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Individual

JAKE EDWARD ENSLIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
402 15TH AVE SE STE 100, PUYALLUP, WA 98372-3709
(253) 697-5200
Mailing address
225 BELLA VISTA DR, FOX ISLAND, WA 98333-9702
(253) 970-6951

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary

Other

Enumeration date
07/06/2021
Last updated
07/06/2021
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