Individual
JEANELLE VEGA CORNELIO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2201 S 19TH ST, TACOMA, WA 98405-2962
(253) 697-8400
Mailing address
814 E 54TH ST, TACOMA, WA 98404-2601
(253) 304-2384
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
08/27/2024
Last updated
08/27/2024
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