Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 156FX1101X | Ophthalmic Assistant |
NPI | 1225496839 |
---|---|
Provider Name | Ms. Jeannette Marie Bowers |
First Address | Tacoma, WA 98431-1100 |
Second Address | Tacoma, WA 98431-1100 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/02/2016 |
Last Update Date | 10/02/2016 |