Individual
JANNAH KOETJE
Active
Sole proprietor
No
Provider details
NPI number
Gender
X
Contact information
Practice address
6409 E MILL PLAIN BLVD, VANCOUVER, WA 98661-7454
(360) 718-8376
Mailing address
4351 COOK UNDERWOOD RD, BINGEN, WA 98605-9035
(360) 480-0989
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
CB61626953
WA
Other
Enumeration date
10/26/2024
Last updated
11/20/2024
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