Individual
JEANIE EDWARDS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMP
Contact information
Practice address
228705 GAME FARM RD, KENNEWICK, WA 99337
(509) 855-1325
(509) 396-9252
Mailing address
P.O. BOX 6445, KENNEWICK, WA 99337
(509) 374-4719
(509) 374-3873
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MA00022225
WA
Other
Enumeration date
08/22/2006
Last updated
03/07/2013
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