Individual
JAMILA NIA MAINOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
8910 VERNON RD, LAKE STEVENS, WA 98258-2400
(425) 397-1704
(425) 335-5145
Mailing address
PO BOX 5127, EVERETT, WA 98206-5127
(425) 397-1704
(425) 335-5145
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
2010003245
MO
207Q00000X
Family Medicine Physician
Primary
MD61215438
WA
207Q00000X
Family Medicine Physician
ME126189
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2210571
—
WA
Enumeration date
09/21/2007
Last updated
07/29/2022
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