Individual
LATRISE JEFFERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
110 IRVING ST NW, WASHINGTON, DC 20010-2976
(202) 877-9696
Mailing address
1000 RIVER RD, STE 100, CONSHOHOCKEN, PA 19428-2439
(800) 355-3818
(610) 834-2862
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
MD034722
DC
Other
Enumeration date
01/17/2007
Last updated
11/27/2007
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