Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 1223P0221X | Pediatric Dentist | 59870 | CA |
Y | 1223P0221X | Pediatric Dentist | DE60285976 | WA |
N | 1223P0221X | Pediatric Dentist | DR20000193 | WA |
NPI | 1013107937 |
---|---|
Provider Name | Jessica R Webb |
First Address | Yakima, WA 98902-6340 |
Second Address | Yakima, WA 98902-6340 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/07/2007 |
Last Update Date | 23/04/2019 |