Individual
JACLYNN L POWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1150 VARNUM ST NE, WASHINGTON, DC 20017-2104
(202) 269-7392
Mailing address
1123 STATE ROUTE 3 NORTH #148, GAMBRILLS, MD 21054-1715
(301) 614-0595
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
35097526
OH
2085R0202X
Diagnostic Radiology Physician
Primary
MD042906
DC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
063357700
—
DC
Enumeration date
03/30/2009
Last updated
06/13/2016
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