Individual
JENNIFER M GARDNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
4225 ROOSEVELT WAY NE, SEATTLE, WA 98105-6099
(206) 598-4067
Mailing address
PO BOX 50095, SEATTLE, WA 98145-5095
(206) 543-6420
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
MD60289724
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1558427146
—
WA
Enumeration date
12/28/2006
Last updated
11/05/2012
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