Individual
DARREL W JERNIGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CG 61020545
Contact information
Practice address
1216 PINE ST STE 300, SEATTLE, WA 98101-1959
(206) 323-1768
(206) 323-2184
Mailing address
1216 PINE ST STE 300, SEATTLE, WA 98101-1959
(206) 323-1768
(206) 323-2184
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
CG61020545
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
23-7258439
NA
WA
Enumeration date
03/04/2020
Last updated
03/04/2020
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