Individual
JENIFFER LEE PANKO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMP
Contact information
Practice address
100 AMOUR CT, WHITE SALMON, WA 98672
(509) 493-4806
Mailing address
PO BOX 1892, WHITE SALMON, WA 98672-1892
(509) 493-4806
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MA00014966
WA
Other
Enumeration date
09/17/2008
Last updated
09/17/2008
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