Individual
MRS. JENNY VIOLET WALTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2616 KWINA RD, BELLINGHAM, WA 98226-9291
(360) 380-6945
(360) 384-2350
Mailing address
2616 KWINA RD, BELLINGHAM, WA 98226-9291
(360) 380-6945
(360) 384-2350
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA10005362
WA
363AM0700X
Medical Physician Assistant
10005362
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8505596
—
WA
Enumeration date
01/16/2008
Last updated
01/27/2015
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