Organization
PORT TOWNSEND FOOT AND ANKLE CLINIC PS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JESSICA L LUND DPM (PRESIDENT)
(360) 385-6486
Entity
Organization
Contact information
Practice address
204 GAINES ST, PORT TOWNSEND, WA 98368-6902
(360) 385-6486
(360) 385-6486
Mailing address
PO BOX 11009, OLYMPIA, WA 98508-1009
(360) 352-2037
(360) 352-0637
Taxonomy
Speciality
Code
Description
License number
State
213ES0131X
Foot Surgery Podiatrist
Primary
PO00000797
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0216774
LABOR & INDUSTRIES
WA
05
—
1123595
—
WA
01
—
P00371973
MEDICARE RR
WA
Enumeration date
02/08/2007
Last updated
02/19/2009
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