Individual
JENNIFER CAROL SHOUP
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PAC
Contact information
Practice address
11400 98TH AVE NE STE 200, KIRKLAND, WA 98033-4306
(360) 220-2585
Mailing address
1802 S UNION AVE, SUITE 200, TACOMA, WA 98405-1947
(253) 752-6965
(253) 759-6056
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA60178872
WA
Other
Enumeration date
08/24/2010
Last updated
01/28/2025
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