Individual
JILL A DUDIK BROSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
615 S DIVISION ST, MOSES LAKE, WA 98837-3800
(509) 766-9450
(509) 766-1954
Mailing address
615 S DIVISION ST, MOSES LAKE, WA 98837-3800
(509) 766-9450
(509) 766-1954
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
MD00025968
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1102730
—
WA
Enumeration date
08/01/2005
Last updated
03/29/2010
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