Provider Demographics
NPI:1376855460
Name:THOMPSON, JENNIFER KELLY (MS)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:KELLY
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 356159
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98195-6159
Mailing Address - Country:US
Mailing Address - Phone:206-598-8130
Mailing Address - Fax:206-598-2359
Practice Address - Street 1:1959 NE PACIFIC ST
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98195-6159
Practice Address - Country:US
Practice Address - Phone:206-598-8130
Practice Address - Fax:206-598-2359
Is Sole Proprietor?:No
Enumeration Date:2010-07-06
Last Update Date:2010-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS