Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 174N00000X | Lactation Consultant | L-98396 |
NPI | 1215481106 |
---|---|
Provider Name | Jessica Wells |
First Address | Vancouver, WA 98663-2706 |
Second Address | Vancouver, WA 98663-2706 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/08/2016 |
Last Update Date | 08/08/2016 |