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Individual

JEFFREY L JENNINGS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
691 S WENAS, SELAH, WA 98942
(509) 480-8258
Mailing address
691 S WENAS, SELAH, WA 98942
(509) 480-8258

Taxonomy

Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
MD00031985
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
8157299
WA
Enumeration date
10/24/2006
Last updated
10/15/2010
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