Individual
JACQUELINE PROUDFOOT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D., M.P.H.
Contact information
Practice address
31 NE STATE ROUTE 300 STE 200, BELFAIR, WA 98528-8668
(360) 377-3776
Mailing address
400 WARREN AVE STE 200, BREMERTON, WA 98337-1467
(360) 377-3776
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
60999446
WA
207Q00000X
Family Medicine Physician
A141233
CA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/23/2014
Last updated
03/07/2022
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