Individual
MS. JENNIFER LYNN WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
19200 N KELSEY ST, MONROE, WA 98272-1431
(360) 794-5555
Mailing address
15426 30TH DR SE, MILL CREEK, WA 98012-5888
(425) 220-7108
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
IR60306113
WA
Other
Enumeration date
07/31/2014
Last updated
07/31/2014
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