Individual
JODI R KIRKWOOD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
204 QUINCE ST NE, SUITE 100, OLYMPIA, WA 98506-4009
(360) 753-7224
(360) 705-2413
Mailing address
PO BOX 1965, OLYMPIA, WA 98507-1965
(360) 753-7224
(360) 705-2413
Taxonomy
Speciality
Code
Description
License number
State
225000000X
Orthotic Fitter
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
203259289-98506-0000
TRICARE
—
01
—
8989CU
REGENCE BLUE SHIELD
—
05
—
9057852
—
WA
Enumeration date
06/27/2008
Last updated
06/27/2008
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