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1093068595
JARED B CORNELISON
OLYMPIA, WA
NPI
1093068595
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363A00000X Physician Assistant
(Licence: WA PA60360929)
Enumeration Date
2012-10-22
Last Update Date
2013-05-28
Business Address
-- JARED B CORNELISON PA-C
3901 CAPITAL MALL DR SW STE A
OLYMPIA, WA 98502-1178
Phone number: 360-786-8990
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Mailing Address
-- JARED B CORNELISON PA-C
431 N 15TH AVE
POCATELLO, ID 83201-4058
Phone number: 208-339-5726
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