Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | ML60019662 | WA |
Y | 2080P0202X | Pediatric Cardiologist | MD60217235 | WA |
NPI | 1194980193 |
---|---|
Provider Name | Ms. Jennie Michelle Allen-Rich |
First Address | Tacoma, WA 98405-4292 |
Second Address | Seattle, WA 98105-3901 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/07/2008 |
Last Update Date | 30/04/2019 |