Provider Demographics
NPI:1598019424
Name:SIMONS, JENNIFER (CD)
Entity Type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:
Last Name:SIMONS
Suffix:
Gender:F
Credentials:CD
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 488
Mailing Address - Street 2:
Mailing Address - City:PRESTON
Mailing Address - State:WA
Mailing Address - Zip Code:98050-0488
Mailing Address - Country:US
Mailing Address - Phone:425-894-3475
Mailing Address - Fax:
Practice Address - Street 1:6208 308TH AVE SE
Practice Address - Street 2:
Practice Address - City:PRESTON
Practice Address - State:WA
Practice Address - Zip Code:98050
Practice Address - Country:US
Practice Address - Phone:425-894-3475
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-30
Last Update Date:2012-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA602887721374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula