Individual
JILLIAN C S LONGWAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPNP
Contact information
Practice address
1628 S MILDRED ST STE 101, TACOMA, WA 98465-1628
(253) 564-8005
Mailing address
1628 S MILDRED ST STE 101, TACOMA, WA 98465-1628
(253) 564-8005
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN60840002
WA
363LP0200X
Pediatric Nurse Practitioner
Primary
AP60849416
WA
Other
Enumeration date
10/01/2014
Last updated
07/25/2024
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