Individual
GREGORY R JESPERSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
19309 218TH PL NE, WOODINVILLE, WA 98077-7112
(425) 788-1484
(425) 788-2024
Mailing address
PO BOX 1786, DUVALL, WA 98019-1786
(425) 788-1484
(425) 788-2024
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
PO00000415
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
213E00000X
—
WA
Enumeration date
11/05/2006
Last updated
11/15/2011
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