Individual
MS. JANA MARIE MATHIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMP
Contact information
Practice address
11801 NE 160TH ST, SUITE D, BOTHELL, WA 98011-4106
(425) 488-3477
(425) 481-8031
Mailing address
11429 81ST AVE NE, KIRKLAND, WA 98034-3558
(425) 829-7517
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MA00012432
WA
Other
Enumeration date
01/10/2007
Last updated
07/08/2007
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