Individual
JEREMIAH NORDSTROM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1520 KELLY PL STE 234, WALLA WALLA, WA 99362-8607
(509) 524-2920
Mailing address
PO BOX 959, YAKIMA, WA 98907-0959
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN61202303
WA
Other
Enumeration date
04/14/2025
Last updated
04/14/2025
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