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Individual
JENNIFER BEART BOLLYKY
Active
Individual
JENNIFER BEART BOLLYKY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
C55872
CA
207R00000X
Internal Medicine Physician
MD00044340
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0192575
L & I WORKERS COMP
WA
01
—
3536BO
REGENCE BLUESHIELD RIDER
WA
05
—
8415879
—
WA
01
—
P00188398
RAILROAD MEDICARE
WA
Enumeration date
04/03/2006
Last updated
04/17/2024
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