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Individual

JESSE LEE FREE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MA, LAT, ATC

Contact information

Practice address
737 LOGAN AVE NORTH, MC 9C-01, RENTON, WA 98057-0000
(425) 512-2704
Mailing address
607 DEWEY AVE NW, SUITE 300, GRAND RAPIDS, MI 49504-7335
(425) 512-2704

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
A160483105
WA

Other

Enumeration date
07/29/2015
Last updated
07/29/2015
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