Provider Demographics
NPI:1114425188
Name:WORKMAN, JENNY SHIRLEY
Entity Type:Individual
Prefix:
First Name:JENNY
Middle Name:SHIRLEY
Last Name:WORKMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:36 WILD TURKEY RD
Mailing Address - Street 2:
Mailing Address - City:EAST WENATCHEE
Mailing Address - State:WA
Mailing Address - Zip Code:98802-8534
Mailing Address - Country:US
Mailing Address - Phone:619-862-4242
Mailing Address - Fax:
Practice Address - Street 1:36 WILD TURKEY RD
Practice Address - Street 2:
Practice Address - City:EAST WENATCHEE
Practice Address - State:WA
Practice Address - Zip Code:98802-8534
Practice Address - Country:US
Practice Address - Phone:619-862-4242
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-01-25
Last Update Date:2018-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALL00004281235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist