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Individual

JESSIE PAULL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
1 BOONE RD, BREMERTON, WA 98312-1894
(360) 475-4396
(360) 475-4221
Mailing address
1 BOONE RD, BREMERTON, WA 98312-1894
(360) 475-4396
(360) 475-4221

Taxonomy

Speciality
Code
Description
License number
State
171000000X
Military Health Care Provider
0101260765
VA
171000000X
Military Health Care Provider
MD61218866
WA
208600000X
Surgery Physician
0101260765
VA
208600000X
Surgery Physician
Primary
MD61218866
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
MD61218866
LICENSE
WA
Enumeration date
04/05/2015
Last updated
01/03/2023
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