Individual
JEANIE COLVIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ADDP COORDINATOR
Contact information
Practice address
11572 17TH AND C ST., JBLM, WA 98433
(253) 966-7680
(253) 967-7216
Mailing address
11572 17TH AND C ST., JBLM, WA 98433
(253) 966-7680
(253) 967-7612
Taxonomy
Speciality
Code
Description
License number
State
126800000X
Dental Assistant
Primary
—
—
Other
Enumeration date
07/20/2016
Last updated
08/22/2019
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