Individual
CLAIRE SOUTHERN JENKINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1355 N 205TH ST, SHORELINE, WA 98133-3215
(206) 542-5656
Mailing address
PO BOX 50095, SEATTLE, WA 98145-5095
(206) 543-6420
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD00044288
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0191609
L&I
WA
05
—
1619067550
—
WA
01
—
327360
INTERNAL ID-MOTOR VEHICLE ID
—
Enumeration date
10/13/2006
Last updated
10/26/2012
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