Individual
JARED HAWTHORNE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
117 E 39TH ST, VANCOUVER, WA 98663-2229
(360) 694-7931
Mailing address
117 E 39TH ST, VANCOUVER, WA 98663-2229
(360) 694-7931
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DE61235268
WA
Other
Enumeration date
07/09/2019
Last updated
01/04/2023
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