Individual
MRS. JESSICA RAE IDDINGS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMP
Contact information
Practice address
1060 HUDSON ST, LONGVIEW, WA 98632-3103
(360) 423-2037
Mailing address
713 NEVADA DR, LONGVIEW, WA 98632-5603
(360) 636-4033
(360) 423-9320
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Enumeration date
02/12/2007
Last updated
07/08/2007
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