Individual ProviderJessica L FullerCounselorBehavioral Health & Social Service ProvidersPractice Address10303 Meridian Ave N Ste 204, Seattle, WA 98133-9483(425) 242-1713(360) 632-5265PECOS EnrollmentBased on the most recent information from CMS, provider Jessica L Fuller 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 11 days ago.Profile DetailsProvider ID1710726880Provider TypeIndividualFull NameFuller, Jessica LGenderFemaleSole ProprietorNoEnumeration Date5/20/2024Last Updated5/20/2024Contact InformationPractice LocationPractice Address10303 Meridian Ave N Ste 204, Seattle, WA 98133-9483Phone(425) 242-1713FaxUnlisted FaxMailing LocationMailing Address15560 Westminster Way N Apt 414, Shoreline, WA 98133-5935Phone(360) 632-5265FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode101Y00000XPrimaryDescriptionCounselorBehavioral Health & Social Service ProvidersLicenseUnlisted IssuerCode390200000XDescriptionStudent in an Organized Health Care Education/Training ProgramStudent, Health CareLicenseUnlisted Issuer