Tenino Family Practice Pllc
NPI #1487056511 in Tenino, Washington
Provider Information
- NPI Number
- 1487056511
- Entity Type
- Organization
- Organization Name
- Tenino Family Practice Pllc
- Primary Specialty
- Family Medicine - Adolescent Medicine
- Enumeration Date
- Sep 19, 2014
- Last Updated
- Sep 19, 2014
Practice Location
- Address
- 273 SUSSEX AVE E
- City
- Tenino
- State
- Washington
- ZIP Code
- 98589-9359
- Phone
- (360) 264-5665
Authorized Official
- Name
- DR. LEYTON ENDICOTT JUMP, MD
- Title
- SOLE MEMBER
- Phone
- (360) 264-5665
Specialties & Taxonomy Codes
| Specialty |
|---|
| Family Medicine - Adolescent Medicine — Adolescent Medicine |
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