Individual ProviderJessica CoronadoCounselorBehavioral Health & Social Service ProvidersPractice Address711 State Ave NE, Olympia, WA 98506-3984(360) 943-0780PECOS EnrollmentBased on the most recent information from CMS, provider Jessica Coronado does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 2 days ago.Profile DetailsProvider ID1174178925Provider TypeIndividualFull NameCoronado, JessicaGenderFemaleSole ProprietorNoEnumeration Date8/8/2019Last Updated11/7/2023Contact InformationPractice LocationPractice Address711 State Ave NE, Olympia, WA 98506-3984Phone(360) 943-0780FaxUnlisted FaxMailing LocationMailing Address711 State Ave NE, Olympia, WA 98506-3984Phone(360) 943-0780FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode101Y00000XPrimaryDescriptionCounselorBehavioral Health & Social Service ProvidersLicenseCG61103418Washington