Individual
JENNIFER KAY EICKSTADT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
6002 N LIDGERWOOD ST, SPOKANE, WA 99208-1124
(509) 482-4402
(509) 482-5071
Mailing address
6002 N LIDGERWOOD ST, SPOKANE, WA 99208-1124
(509) 482-4402
(509) 482-5071
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
PA-880
ID
363AM0700X
Medical Physician Assistant
Primary
PA60188676
WA
Other
Enumeration date
12/01/2010
Last updated
03/30/2021
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