Individual
JILL WILTFONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
9441 LBJ FWY, SUITE 602, DALLAS, TX 75243-4545
(469) 249-1887
Mailing address
14342 126TH AVE NE, A302, KIRKLAND, WA 98034-1537
(206) 947-2898
Taxonomy
Speciality
Code
Description
License number
State
282N00000X
General Acute Care Hospital
Primary
282N00000X
WA
Other
Enumeration date
12/18/2014
Last updated
12/18/2014
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