Mrs Jessie Jiyeon Dziduch, FNP-C - Medicare Nurse Practitioner in Arlington, WA

Mrs Jessie Jiyeon Dziduch, FNP-C is a medicare enrolled "Nurse Practitioner" physician in Arlington, Washington. Her current practice location is 4011 172nd St Ne, Arlington, Washington. You can reach out to her office (for appointments etc.) via phone at (142) 525-9096.

Mrs Jessie Jiyeon Dziduch is licensed to practice in Washington (license number AP61340468) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1265900591.

Contact Information

Mrs Jessie Jiyeon Dziduch, FNP-C
4011 172nd St Ne,
Arlington, WA 98223-8482
(142) 525-9096
Not Available



Physician's Profile

Full NameMrs Jessie Jiyeon Dziduch
GenderFemale
SpecialityNurse Practitioner
Location4011 172nd St Ne, Arlington, Washington
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1265900591
  • Provider Enumeration Date: 11/05/2018
  • Last Update Date: 10/23/2023
  Medicare PECOS Information:
  • PECOS PAC ID: 4082079728
  • Enrollment ID: I20230502000585

Medical Identifiers

Medical identifiers for Mrs Jessie Jiyeon Dziduch such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1265900591NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
207Q00000XFamily Medicine AP11023 (Arizona)Secondary
363LF0000XNurse Practitioner - Family AP61340468 (Washington)Secondary
363LF0000XNurse Practitioner - Family AP11023 (Arizona)Secondary
363L00000XNurse Practitioner AP61340468 (Washington)Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Mrs Jessie Jiyeon Dziduch allows following entities to bill medicare on her behalf.
Entity NameThe Little Clinic Of Arizona Llc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1023216249
PECOS PAC ID: 4981797982
Enrollment ID: O20070907000182

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Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mrs Jessie Jiyeon Dziduch is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Mrs Jessie Jiyeon Dziduch, FNP-C
Po Box 5127,
Everett, WA 98206-5127

Ph: (425) 304-8431
Mrs Jessie Jiyeon Dziduch, FNP-C
4011 172nd St Ne,
Arlington, WA 98223-8482

Ph: (142) 525-9096

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