Individual
JEREMY THOMAS PAPE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
325 E PIONEER AVE, PUYALLUP, WA 98372-3265
(253) 445-8120
(253) 697-3730
Mailing address
325 E PIONEER AVE, PUYALLUP, WA 98372-3265
(253) 445-8120
(253) 697-3730
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100270530A
—
IN
Enumeration date
11/22/2006
Last updated
09/02/2011
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