Individual
MAITRI JETLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3526 SE NAVIGATION LN APT 101, PORT ORCHARD, WA 98366-2884
(630) 631-9770
Mailing address
3526 SE NAVIGATION LN APT 101, PORT ORCHARD, WA 98366-2884
(630) 631-9770
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
61457549
WA
Other
Enumeration date
01/08/2024
Last updated
01/08/2024
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