Individual
JENNA LAWREY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2426 N MERRITT CREEK LOOP STE A, COEUR D ALENE, ID 83814-4961
(208) 819-2183
Mailing address
8610 N CAMPBELL RD, OTIS ORCHARDS, WA 99027-9205
(509) 808-0641
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
PA-2607
ID
363A00000X
Physician Assistant
Primary
PA.PA.61479317
WA
363A00000X
Physician Assistant
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—
Other
Enumeration date
06/10/2022
Last updated
10/21/2023
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