NPI | 1346623048 |
---|---|
Former Name | JESSICA RENAE KOSKI |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WA AP60573932) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WA CO61324263) |
Enumeration Date | 2015-06-30 |
Last Update Date | 2022-06-29 |