Individual
MS. JENNA LEE HARRISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
921 14TH AVENUE, LONGVIEW, WA 98632
(360) 423-0203
(360) 423-2311
Mailing address
921 14TH AVENUE, LONGVIEW, WA 98632
(360) 423-0203
(360) 577-0269
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
60377889
WA
164W00000X
Licensed Practical Nurse
LP60377889
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1980903
—
WA
05
—
2098501
—
WA
Enumeration date
03/13/2015
Last updated
05/02/2019
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