Individual
MRS. JENNIFER MARIE STOUDT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMP
Contact information
Practice address
318 GARDEN AVE N, RENTON, WA 98057-5729
(425) 231-8042
Mailing address
1611 116TH AVE NE STE 200, BELLEVUE, WA 98004-3064
(425) 455-0088
(425) 455-0340
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MA60197769
WA
Other
Enumeration date
04/04/2011
Last updated
08/15/2012
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