Individual
MS. TRACEY LYNN JENKINS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMP
Contact information
Practice address
222 NE 4TH AVE, CAMAS, WA 98607-2124
(360) 772-5662
Mailing address
222 NE 4TH AVE, CAMAS, WA 98607-2124
(360) 772-5662
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MA60594177
WA
Other
Enumeration date
11/12/2015
Last updated
11/12/2015
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