Provider Demographics
NPI:1114044054
Name:HARVILL, JILL DAWN (ATC)
Entity Type:Individual
Prefix:
First Name:JILL
Middle Name:DAWN
Last Name:HARVILL
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:98 JANELLE LN
Mailing Address - Street 2:
Mailing Address - City:BURBANK
Mailing Address - State:WA
Mailing Address - Zip Code:99323-9707
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1979 SNYDER ST
Practice Address - Street 2:SUITE 150
Practice Address - City:RICHLAND
Practice Address - State:WA
Practice Address - Zip Code:99354-5319
Practice Address - Country:US
Practice Address - Phone:509-376-2886
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer