Individual
JILLENE M LUND
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT00008461
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0290926
DEPT. OF LABOR AND INDUSTRIES
WA
01
—
181190
DEPT OF L&I
WA
01
—
2043LU
REGENCE B/S
WA
05
—
8333866
—
WA
01
—
8938975
CRIME VICTIMS
WA
01
—
A024
TRICARE
WA
Enumeration date
08/25/2005
Last updated
07/13/2015
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