Individual
MR. JIMMY K ELISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
250 FORT STREET, NEAH BAY, WA 98357
(360) 645-2233
(360) 645-2305
Mailing address
PO BOX 410, NEAH BAY, WA 98357-0410
(360) 645-2233
(360) 645-2305
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
N00822
ID
Other
Enumeration date
03/06/2007
Last updated
07/08/2007
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