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Individual

JO ELLA LEE PHILLIPS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
1313 N 13TH AVE, WALLA WALLA, WA 99362-8817
(208) 284-0999
Mailing address
1313 N 13TH AVE, WALLA WALLA, WA 99362-8817
(208) 284-0999

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA.PA:60312122
WA

Other

Enumeration date
12/06/2012
Last updated
12/06/2012
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