Individual
JESSICA JO DESHAYES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMP
Contact information
Practice address
5963 SW CARROLL ST, SEATTLE, WA 98116-3528
(206) 387-3944
Mailing address
5963 SW CARROLL ST, SEATTLE, WA 98116-3528
(206) 387-3944
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MA00010870
WA
Other
Enumeration date
01/10/2007
Last updated
07/08/2007
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