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Individual

J K VAN ETTEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
2500 METROHEALTH DR, CLEVELAND, OH 44109-1900
(216) 778-4486
Mailing address
3640 NE SITKA DR, CAMAS, WA 98607-7473

Taxonomy

Speciality
Code
Description
License number
State
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
Primary
MD61136032
WA
390200000X
Student in an Organized Health Care Education/Training Program

Other

Enumeration date
03/21/2018
Last updated
12/21/2021
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