Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 124Q00000X | Dental Hygienist | DH 00007232 | WA |
NPI | 1023448768 |
---|---|
Provider Name | Tamera Jancze |
First Address | Vancouver, WA 98684-6053 |
Second Address | Vancouver, WA 98684-6053 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/11/2013 |
Last Update Date | 28/12/2021 |