Individual
DR. JEAN ANN WHARTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
509 SOUTH SECOND STREET, LACONNER, WA 98257
(360) 466-4826
(360) 466-4826
Mailing address
PO BOX 249, LA CONNER, WA 98257-0249
(360) 466-4826
(360) 466-4826
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
—
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
35454
TRICARE
—
Enumeration date
11/14/2006
Last updated
07/08/2007
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