Individual
JESSY KRALLUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
FNP-C
Contact information
Practice address
6240 TACOMA MALL BLVD STE 101, TACOMA, WA 98409-6819
(253) 271-9720
(720) 598-0440
Mailing address
6240 TACOMA MALL BLVD STE 101, TACOMA, WA 98409-6819
(253) 271-9720
(720) 598-0440
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
AP61044253
WA
363LF0000X
Family Nurse Practitioner
202001367NP-PP
OR
Other
Enumeration date
02/12/2020
Last updated
04/09/2021
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