Individual
JENNETTE MARIE ANDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
9040A JACKSON AVE JOINT BASE LEWIS-MCCHORD, TACOMA, WA 98431-0001
(909) 560-2683
Mailing address
WH3S9A, 549 HC / BAACH UNIT 15245, APO, AP 96271
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
19829
CA
Other
Enumeration date
08/04/2008
Last updated
07/14/2021
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