Provider Information for 1366626640
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JEFFREY EUGENE FOSTER M.S., M.A.
Sex: Male
NPI: 1366626640
Last Updated: 2007-12-22
Certification Date:
Certification Date:
Details
| Name | Value | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| NPI | 1366626640 | ||||||||
| Enumeration Date | 2007-12-22 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | YES | ||||||||
| Status | Active | ||||||||
| Mailing Address | 400 E EVERGREEN BLVD SUITE 124 VANCOUVER, WA 98660-3331 United States Phone: 360-694-1744 | Fax:360-694-6002 | ||||||||
| Primary Practice Address | 400 E EVERGREEN BLVD SUITE 124 VANCOUVER, WA 98660-3331 United States Phone: 360-694-1744 | Fax:360-694-6002 | ||||||||
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