Provider Demographics
NPI:1053448910
Name:BARRETT, JENNIFER LYNN (DC,BS, LMP)
Entity Type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:LYNN
Last Name:BARRETT
Suffix:
Gender:F
Credentials:DC,BS, LMP
Other - Prefix:MISS
Other - First Name:JENNIFER
Other - Middle Name:LYNN
Other - Last Name:NISHIMURA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BS, LMP
Mailing Address - Street 1:10525 STATE AVE STE 1
Mailing Address - Street 2:
Mailing Address - City:MARYSVILLE
Mailing Address - State:WA
Mailing Address - Zip Code:98271-7216
Mailing Address - Country:US
Mailing Address - Phone:360-657-1262
Mailing Address - Fax:
Practice Address - Street 1:10525 STATE AVE STE 1
Practice Address - Street 2:
Practice Address - City:MARYSVILLE
Practice Address - State:WA
Practice Address - Zip Code:98271-7216
Practice Address - Country:US
Practice Address - Phone:360-657-1262
Practice Address - Fax:360-658-4127
Is Sole Proprietor?:No
Enumeration Date:2007-02-27
Last Update Date:2012-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH 60264422111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor