Individual
JANE CONNELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4404 NW BASS ST, CAMAS, WA 98607-8305
(360) 921-9001
Mailing address
4404 NW BASS ST, CAMAS, WA 98607-8305
(360) 921-9001
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
60088133
WA
Other
Enumeration date
10/18/2023
Last updated
10/18/2023
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