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Individual

JENNIFER YEALY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
200 MEMORIAL DR, LURAY, VA 22835
(540) 743-4561
Mailing address
PO BOX 3777, PORTLAND, OR 97208-3777
(503) 413-3900
(503) 413-3710

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA187741
OR
363AM0700X
Medical Physician Assistant
0110005197
VA

Other

Enumeration date
01/30/2016
Last updated
07/17/2018
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