Individual
JAMIE BRACKENBURY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RDH
Contact information
Practice address
9202 W GAGE BLVD APT R202, KENNEWICK, WA 99336-7138
(208) 412-9114
Mailing address
9202 W GAGE BLVD APT R202, KENNEWICK, WA 99336-7138
(208) 412-9114
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
HL00007968
WA
Other
Enumeration date
10/04/2007
Last updated
10/04/2007
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