Individual
JOSPEH W GLENN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
NP-C
Contact information
Practice address
9040 JACKSON AVE, MADIGAN ARMY MEDICAL CENTER WTB CLINIC, TACOMA, WA 98431-5000
(785) 239-7582
(785) 239-7364
Mailing address
PO BOX 33194, FORT LEWIS, WA 98433-0194
(216) 702-6833
(253) 968-3474
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
A02941
AR
363LP2300X
Primary Care Nurse Practitioner
COA 09013-NP
OH
Other
Enumeration date
04/22/2010
Last updated
11/05/2012
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