Individual
JESSICA R MAIKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
413 LILLY RD NE, OLYMPIA, WA 98506-5133
(360) 493-4083
Mailing address
PO BOX 3360, PORTLAND, OR 97208-3360
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
AP60903621
WA
Other
Enumeration date
10/18/2017
Last updated
06/17/2021
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