Individual
MS. JILL ELIZABETH ANDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMP
Contact information
Practice address
1110 7TH CT, FOX ISLAND, WA 98333
(360) 878-0530
Mailing address
1110 7TH CT, FOX ISLAND, WA 98333
(360) 878-0530
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MA00021191
WA
Other
Enumeration date
09/16/2010
Last updated
09/16/2010
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