Individual
JENNIFER ESMERALDA FAVELA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
17018 15TH AVE NE, SHORELINE, WA 98155-5126
(206) 363-6864
Mailing address
17018 15TH AVE NE, SHORELINE, WA 98155-5126
(206) 363-6864
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
02/11/2020
Last updated
02/12/2020
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