Individual
JUSTIN CHARLES JENKINS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
6615 6TH AVE, TACOMA, WA 98406-2027
(253) 565-7110
(253) 565-7110
Mailing address
2914 S 14TH ST, TACOMA, WA 98405-2407
(253) 227-6428
(253) 565-7110
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MAOOO16111
WA
Other
Enumeration date
11/08/2007
Last updated
11/08/2007
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