Individual
KJERSTEN GORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
4012 WIGGINS RD SE, OLYMPIA, WA 98501-4372
(360) 491-1036
(360) 491-1416
Mailing address
3709 15TH AVENUE CT NW, GIG HARBOR, WA 98335-1672
(253) 376-2382
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LP60839655
WA
Other
Enumeration date
06/26/2018
Last updated
06/26/2018
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