Individual
JESSICA OPAL GARDNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
3801 5TH ST SE, 220, PUYALLUP, WA 98374-2106
(253) 445-4258
Mailing address
11711 NE 12TH ST, SUITE 3A, BELLEVUE, WA 98005-2461
(425) 452-0704
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PU60381099
WA
Other
Enumeration date
05/29/2013
Last updated
05/29/2013
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