Individual
MRS. JEANNETTE V LUTHER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
8507 S 5TH ST, SUITE 113, RIDGEFIELD, WA 98642-3421
(360) 887-9494
(360) 887-9498
Mailing address
1718 E KESSLER BLVD, LONGVIEW, WA 98632
(360) 747-5800
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA10003342
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8320889
—
WA
Enumeration date
11/21/2005
Last updated
05/16/2017
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