Individual
DR. JAMIE L SOUTHARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
113 S 11TH ST, MOUNT VERNON, WA 98274-4025
(360) 488-2123
(360) 404-3906
Mailing address
113 S 11TH ST, MOUNT VERNON, WA 98274-4025
(360) 488-2123
(360) 404-3906
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
CH00034154
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8346116
—
WA
Enumeration date
08/09/2005
Last updated
11/13/2024
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