Individual
MISS JENNIFER ROSE IVEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPC
Contact information
Practice address
3285 FERGUSON STREET SW, TUMWATER, WA 98512
(360) 943-1907
Mailing address
7408 VANDERMARK RD E, BONNEY LAKE, WA 98391-8664
(253) 355-1996
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
WA
Other
Enumeration date
07/22/2019
Last updated
07/22/2019
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