Individual
JUSTIN WIMPRESS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1707 COOKS HILL RD, CENTRALIA, WA 98531-9071
(360) 523-8762
Mailing address
PO BOX 1165, CASTLE ROCK, WA 98611-1165
(541) 272-9469
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
05/15/2020
Last updated
05/15/2020
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