Individual
MS. JACQUELINE TULLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
13115 NE 4TH ST, SUITE 100, VANCOUVER, WA 98684-5957
(360) 696-1070
Mailing address
13115 NE 4TH ST, SUITE 100, VANCOUVER, WA 98684-5957
(360) 696-1070
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
07481
OR
225100000X
Physical Therapist
Primary
P1 60033939
WA
Other
Enumeration date
07/19/2016
Last updated
07/25/2016
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