Individual
JEANETTE LILLIAN LUNDBERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
300 E COLLEGE WAY, SUITE B, MOUNT VERNON, WA 98273-5429
(360) 428-6677
(369) 428-7635
Mailing address
PO BOX 1789, MOUNT VERNON, WA 98273-1789
(360) 428-6677
(360) 428-7635
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT00000784
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7035843
—
WA
Enumeration date
10/21/2005
Last updated
02/05/2009
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