Individual
MS. JENNIFER DOUGLAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN00123804
Contact information
Practice address
1520 KELLY PL STE 220, WALLA WALLA, WA 99362-8607
(509) 520-2924
Mailing address
PO BOX 1595, 1520 KELLY PLACE, SUITE 220, WALLA WALLA, WA 99362-0329
(509) 520-2924
Taxonomy
Speciality
Code
Description
License number
State
163WA2000X
Administrator Registered Nurse
RN00123804
WA
163WS0200X
School Registered Nurse
RN00123804
WA
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
AP60427024
WA
Other
Enumeration date
01/03/2013
Last updated
01/15/2014
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