Individual
MS. JESSICA ROSE LOUISE HIATT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMP
Contact information
Practice address
120 E BIRCH ST, SUITE 2, WALLA WALLA, WA 99362-3054
(509) 240-4424
Mailing address
2562 S WILBUR AVE, WALLA WALLA, WA 99362-8705
(509) 240-4424
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MA 00024905
WA
Other
Enumeration date
01/14/2009
Last updated
01/14/2009
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