Individual
JODI C NEGRETE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMP
Contact information
Practice address
1025 BLACK LAKE BLVD SW, OLYMPIA, WA 98502-1120
(360) 402-6284
Mailing address
3906 COOPER CREST DR NW, OLYMPIA, WA 98502-4071
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MA00020160
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MA00020160
LMP
WA
Enumeration date
12/20/2006
Last updated
04/16/2008
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