Individual
JENNIFER M PROUSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
400 NE MOTHER JOSEPH PL, VANCOUVER, WA 98664-3200
(360) 514-2559
(360) 514-3590
Mailing address
400 NE MOTHER JOSEPH PL, VANCOUVER, WA 98664-3200
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
DI00001264
WA
Other
Enumeration date
10/23/2006
Last updated
07/08/2007
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