Individual
MATTHEW JELLERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
851 POPLAR PL S, SEATTLE, WA 98144-2827
(206) 322-2387
(206) 322-6306
Mailing address
851 POPLAR PL S, SEATTLE, WA 98144-2827
(206) 322-2387
(206) 322-6306
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
CG60150915
WA
Other
Enumeration date
11/08/2018
Last updated
11/08/2018
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