Individual
JENNIE SHAE WASHINGTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1323 W KEETOOWAH ST, TAHLEQUAH, OK 74464-3462
(918) 506-6901
Mailing address
19839 W 864 RD, PARK HILL, OK 74451-3015
(918) 718-1980
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
07/27/2022
Last updated
07/27/2022
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