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Individual

JACKIE RAE KUNKLE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
RDH

Contact information

Practice address
8712 ONE HALF E MARINGO DR, SPOKANE, WA 99212-1822
(509) 535-8760
(509) 325-3919
Mailing address
8712 ONE HALF E MARINGO DR, SPOKANE, WA 99212-1822
(509) 535-8760
(509) 535-8760

Taxonomy

Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
5900014
WA
Enumeration date
09/18/2007
Last updated
09/18/2007
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