Individual
MRS. JAIME MELLOR VANTINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
1210 W FAIRVIEW ST, COLFAX, WA 99111-9552
(509) 397-4717
(509) 397-3501
Mailing address
1210 W FAIRVIEW ST, COLFAX, WA 99111-9552
(509) 397-4717
(509) 397-3501
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
AP60393668
WA
Other
Enumeration date
01/16/2008
Last updated
08/13/2019
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