Individual provider Active NPI

Jessica Provost, ARNP, DNP

  • Acute Care Nurse Practitioner
  • Seattle, WA
National Provider Identifier
1225758865
Registry record updated Jun 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
AP61688421 Issued in WA
Practice address
825 Eastlake Ave E
Seattle, WA 98109-4405
Phone
(206) 520-5000
NPI assigned
Sep 2, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X RN60739897 WA
Acute Care Nurse Practitioner 363LA2100X AP61688421 WA Primary

Addresses

Primary practice location

825 Eastlake Ave E
Seattle, WA 98109-4405

Mailing address

PO Box 50095
Seattle, WA 98145-5095
Phone (206) 520-5700

Other names 1

  • Jessica Dziala Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250623002892 WA Practitioner - Nurse Practitioner 4688186968 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Association of University PhysiciansGroup PAC ID 0446162697, 3,484 clinicians

Practice addresses (Care Compare)

1701 Columbia Rd
Seattle, WA 98195-0001
Phone (206) 598-3100

1959 NE Pacific St
Seattle, WA 98195-0001
Phone (206) 598-4333

825 Eastlake Ave E
Seattle, WA 98109-4405
Phone (206) 288-1000

Hospital & facility affiliations

  • Fred Hutchinson Cancer Center Hospital, Seattle, WA, CCN 500138
  • University of Washington Medical Ctr Hospital, Seattle, WA, CCN 500008

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
The Association of University Physicians CurrentSince Jun 10, 2025 Accepting new patients

Locations

825 Eastlake Ave E
Seattle, WA 98109
Phone (206) 288-1000

1959 NE Pacific St
Seattle, WA 98195
Phone (206) 598-4333

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1662076800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749513600000",
    "number": "1225758865",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 50095",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981455095",
            "telephone_number": "206-520-5700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "825 EASTLAKE AVE E",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981094405",
            "telephone_number": "206-520-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PROVOST",
        "first_name": "JESSICA",
        "credential": "ARNP, DNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-09-02",
        "last_updated": "2025-06-10",
        "certification_date": "2025-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WA",
            "license": "RN60739897",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "WA",
            "license": "AP61688421",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JESSICA",
            "last_name": "DZIALA",
            "credential": "ARNP, DNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Seattle, WA

Sources for this page

Verify at the official NPI Registry.