Provider Demographics
NPI:1396951943
Name:MENETREY, JAMMIE ELIZABETH (DO, MBA)
Entity type:Individual
Prefix:DR
First Name:JAMMIE
Middle Name:ELIZABETH
Last Name:MENETREY
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Gender:F
Credentials:DO, MBA
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Mailing Address - Street 1:1400 E KINCAID ST
Mailing Address - Street 2:
Mailing Address - City:MOUNT VERNON
Mailing Address - State:WA
Mailing Address - Zip Code:98274-4127
Mailing Address - Country:US
Mailing Address - Phone:360-814-2500
Mailing Address - Fax:360-445-8592
Practice Address - Street 1:307 S 13TH ST STE 300
Practice Address - Street 2:
Practice Address - City:MOUNT VERNON
Practice Address - State:WA
Practice Address - Zip Code:98274-4100
Practice Address - Country:US
Practice Address - Phone:360-336-9757
Practice Address - Fax:360-814-5237
Is Sole Proprietor?:No
Enumeration Date:2007-05-14
Last Update Date:2021-08-10
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PAOS015706207RC0000X
WAOP61166749207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA102845643Medicaid
PA102845643Medicaid