MRS. Jessica Rae Iddings, LMP

NPI #1982746558 in Longview, Washington

Provider Information

NPI Number: 1982746558
Entity Type: Individual
Name: MRS. Jessica Rae Iddings, LMP
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Specialist
Credential: LMP
Enumeration Date: Feb 12, 2007
Last Updated: Jul 8, 2007

Practice Location

Address: 1060 HUDSON ST
City: Longview
State: Washington
ZIP Code: 98632-3103
Phone: (360) 423-2037

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Specialist	174400000X	Primary

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