Individual
MISS JENNIFER GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
914 S SCHEUBER RD, CENTRALIA, WA 98531-9027
(508) 243-9771
Mailing address
152 WALTON CIR, PARIS, TN 38242-9400
(508) 243-9771
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
05/01/2019
Last updated
05/01/2019
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