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Individual

JENELLE LYNN ASHMORE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
22526 SE 64TH PL STE 210, ISSAQUAH, WA 98027-5368
(190) 999-3404
Mailing address
PO BOX 451, BUCKLEY, WA 98321-0451
(909) 993-4043

Taxonomy

Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-17-36067
WA

Other

Enumeration date
06/11/2018
Last updated
06/11/2018
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