Individual
JILLIAN DENICE CALHOUN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1806 W LINCOLN AVE, YAKIMA, WA 98902-2473
(509) 452-4520
(509) 452-5224
Mailing address
501 S 5TH AVE, YAKIMA, WA 98902-3550
(509) 494-6700
(509) 573-6275
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA10005299
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0225792
LABOR & INDUSTRIES
WA
01
—
0301849
LABOR AND INDUSTRIES
WA
05
—
2011646
—
WA
Enumeration date
10/22/2007
Last updated
10/30/2019
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