Individual
JESSICA LAZAR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
506 LAKE ST, KENAI, AK 99611-6937
(907) 714-4025
(844) 412-3952
Mailing address
903 32ND AVE E, SEATTLE, WA 98112-3702
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
165745
AK
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/23/2017
Last updated
12/18/2020
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