Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Jennifer A Castelluccio, PAC

Individual provider Medical Physician Assistant · NPI 1679561435

Jennifer A Castelluccio, PAC is a Medical Physician Assistant in Maple Valley, Washington. Licensed in Washington. Registered with an NPI since 2005.

Licensed in
WA
In the registry since
2005
Specialties on file
2
What do these letters mean?
PAC — Physician Assistant, Certified
A physician assistant holding current national certification; usually written PA-C.

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Practice location Address checks out

26458 Maple Valley Black Diamond Rd SE
Maple Valley, WA 98038
Phone: (425) 690-3460
Fax: (425) 690-9460
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence OA10000132 (WA)
Medical Physician Assistant Taxonomy 363AM0700X · Licence OA10000132 (WA)

Record details

NPI number1679561435
Entity typeIndividual (Type 1)
GenderFemale
Credentials PAC
Sole proprietorNo
NPI enumeratedOctober 6, 2005
Last updated in NPPESAugust 17, 2021
Certification dateAugust 17, 2021

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