| NPI | 1598014565 |
|---|---|
| Former Name | JENNIFER MICHELLE MCCOY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WA PA60314279) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: WA PA60314279) |
| Enumeration Date | 2012-09-05 |
| Last Update Date | 2025-08-12 |