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Organization

GREGORY R JESPERSEN & CATHY L THOSATH

Active
Organization subpart
No

Provider details

NPI number
Authorized official
GREGORY JESPERSEN D.P.M. (OWNER)
(425) 788-1484
Entity
Organization

Contact information

Practice address
19309 218TH PL NE, WOODINVILLE, WA 98077-7112
(425) 788-1484
(425) 788-2024
Mailing address
19309 218TH PL NE, WOODINVILLE, WA 98077-7112
(425) 788-1484

Taxonomy

Speciality
Code
Description
License number
State
213EP1101X
Primary Podiatric Medicine Podiatrist
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
7083165
WA
Enumeration date
05/20/2007
Last updated
02/27/2015
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