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Individual

MRS. JEWELENE RAE PATTULLO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
14406 NE 20TH AVE, VANCOUVER, WA 98686-1448
(360) 418-6001
Mailing address
4805 NE 52ND CIR, VANCOUVER, WA 98661-7805
(360) 695-4912

Taxonomy

Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
DO00001723
WA

Other

Enumeration date
08/24/2006
Last updated
07/08/2007
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