Individual
MISS JENNIFER JUSTESEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2200 S MAIERS RD APT B, MOSES LAKE, WA 98837-8818
(509) 764-8626
(509) 764-8628
Mailing address
2200 S MAIERS RD APT B, MOSES LAKE, WA 98837-8818
(509) 764-8626
(509) 764-8628
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MA00023354
WA
Other
Enumeration date
12/27/2007
Last updated
12/27/2007
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