Individual
JEANIE MARIE LIGHTFOOT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
9040A JACKSON AVE, TACOMA, WA 98431
(253) 968-0111
Mailing address
3508 366TH ST E, EATONVILLE, WA 98328-8281
(540) 419-4126
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
AP60510299
WA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
11/15/2012
Last updated
07/29/2021
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