Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 102L00000X | Psychologist | 1675 | WA |
Y | 103T00000X | Psychologist | 1675 | WA |
NPI | 1003867995 |
---|---|
Provider Name | Dr. Jeffrey M Ulmer |
First Address | Winthrop, WA 98862-9140 |
Second Address | Winthrop, WA 98862-5001 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/05/2006 |
Last Update Date | 14/03/2014 |