Individual
JARRON MITCHELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
117 S 2ND ST, SELAH, WA 98942-1307
(509) 697-9109
(509) 697-9122
Mailing address
16083 SW UPPER BOONES FERRY RD, SUITE 300, TIGARD, OR 97224-7736
(800) 219-8835
(503) 693-9699
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT60091500
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1205064193
—
WA
01
—
P01322183
RR
WA
Enumeration date
06/30/2009
Last updated
07/29/2014
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