Individual
JESSICA WINARTO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
217 S 2ND AVE, WALLA WALLA, WA 99362-3002
(509) 779-8603
Mailing address
217 S 2ND AVE, WALLA WALLA, WA 99362-3002
(509) 779-8603
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
WA
Other
Enumeration date
06/09/2026
Last updated
06/09/2026
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