Individual
JENNIFER MAXON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
534 S 3RD AVE STE 101, WALLA WALLA, WA 99362-3177
(509) 525-0704
Mailing address
PO BOX 1075, WALLA WALLA, WA 99362-0021
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN60189296
WA
Other
Enumeration date
10/20/2021
Last updated
10/20/2021
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