Provider Demographics
NPI:1154637866
Name:PRITCHARD, JLYN ALISHA (DO)
Entity Type:Individual
Prefix:DR
First Name:JLYN
Middle Name:ALISHA
Last Name:PRITCHARD
Suffix:
Gender:F
Credentials:DO
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Mailing Address - Street 1:945 GOETHALS DR
Mailing Address - Street 2:STE 300
Mailing Address - City:RICHLAND
Mailing Address - State:WA
Mailing Address - Zip Code:99352-3552
Mailing Address - Country:US
Mailing Address - Phone:509-943-3196
Mailing Address - Fax:509-946-0455
Practice Address - Street 1:104 W 5TH AVE
Practice Address - Street 2:SUITE 200W
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99204-4880
Practice Address - Country:US
Practice Address - Phone:509-624-2313
Practice Address - Fax:509-459-0686
Is Sole Proprietor?:No
Enumeration Date:2010-08-19
Last Update Date:2015-10-16
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Provider Licenses
StateLicense IDTaxonomies
390200000X
WAOP60317043207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
RES000OtherRES000