Individual
JENNIFER JOLINE PROCTOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
307 W COTA ST, SHELTON, WA 98584-2265
(360) 628-0540
Mailing address
4737 AUSTIN LN SE, LACEY, WA 98503-2161
(360) 628-0540
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
61057648
WA
Other
Enumeration date
10/07/2024
Last updated
10/07/2024
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