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Individual

JODI GRANGER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
13820 19TH AVE NE, TULALIP, WA 98271-6706
(425) 238-3643
Mailing address
12315 RAINBOW DR, ARLINGTON, WA 98223-5875
(425) 268-9406

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN61051755
WA
164W00000X
Licensed Practical Nurse
LP60978864
WA

Other

Enumeration date
08/04/2019
Last updated
12/20/2022
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