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Individual

MRS. JENNIFER E PENROSE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PT

Contact information

Practice address
1445 GALAXY DR NE, SUITE 301, LACEY, WA 98516-4746
(360) 456-1444
(360) 456-1883
Mailing address
1445 GALAXY DR NE, SUITE 301, LACEY, WA 98516-4746
(360) 456-1444
(360) 456-1883

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT00008404
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0222918
LABOR AND INDUSTRIES
WA
05
8342131
WA
Enumeration date
08/10/2005
Last updated
08/27/2007
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