Individual
JESSICA COSTELLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
800 N MEDCALF LN, MONTESANO, WA 98563-1318
(360) 249-2273
(360) 249-2363
Mailing address
800 N MEDCALF LN, MONTESANO, WA 98563-1318
(360) 249-2273
(360) 249-2363
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
P1 60235544
WA
Other
Enumeration date
09/17/2015
Last updated
09/17/2015
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