Individual
JESSE CHARLES WASHBURN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
190 S HIGHWAY 165, PROVIDENCE, UT 84332-9512
(435) 755-3300
(435) 755-3332
Mailing address
PO BOX 27128, SALT LAKE CITY, UT 84127-0128
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
9021346-1204
UT
Other
Enumeration date
07/05/2011
Last updated
06/06/2023
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