Individual
JENNIFER WYATT
Active
Sole proprietor
Provider details
NPI number
Gender
F
Contact information
Practice address
7525 SE 24TH ST, SUITE 510, MERCER ISLAND, WA 98040-2336
(425) 455-2630
Mailing address
1188 106TH AVE NE, SUITE 100, BELLEVUE, WA 98004-8614
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT00008318
WA
Other
Enumeration date
03/28/2006
Last updated
07/08/2007
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