Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 124Q00000X | Dental Hygienist | DH00007907 | WA |
NPI | 1003442245 |
---|---|
Provider Name | Mrs. Bobbi Jean Thompson |
First Address | Kennewick, WA 99338-7623 |
Second Address | Pasco, WA 99301-4153 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/03/2020 |
Last Update Date | 19/03/2020 |