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Individual

JILLENE M LUND

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PT

Contact information

Practice address
21806 103RD AVENUE CT E, #202, GRAHAM, WA 98338-8115
(253) 847-3700
(253) 847-9622
Mailing address
790 REMINGTON BLVD, BOLINGBROOK, IL 60440-4909
(630) 296-2223

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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