Provider Demographics
NPI:1497982359
Name:HOSNER, JENNIFER NICOLE
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:NICOLE
Last Name:HOSNER
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 1:26200 PACIFIC HWY S
Mailing Address - Street 2:
Mailing Address - City:KENT
Mailing Address - State:WA
Mailing Address - Zip Code:98032-6934
Mailing Address - Country:US
Mailing Address - Phone:253-941-4660
Mailing Address - Fax:253-946-8492
Practice Address - Street 1:8707 S 258TH PL
Practice Address - Street 2:#231
Practice Address - City:KENT
Practice Address - State:WA
Practice Address - Zip Code:98030-6379
Practice Address - Country:US
Practice Address - Phone:360-672-0054
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-18
Last Update Date:2021-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA60071093225700000X
WAVA60086966183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist