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Individual

POLLY WASHBURN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
1535 W HIGHLAND AVE, SAN BERNARDINO, CA 92411-1235
(909) 880-6839
Mailing address
1535 W HIGHLAND AVE, SAN BERNARDINO, CA 92411-1235

Taxonomy

Speciality
Code
Description
License number
State
163WS0200X
School Registered Nurse
Primary
334754
CA
363LP0200X
Pediatric Nurse Practitioner
21467
CA

Other

Enumeration date
01/27/2014
Last updated
02/03/2014
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