Joanne Marie Fowler, LMP
Individual provider Active NPI Contractor · Kent, WA
NPI 1922129709 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1922129709
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Contractor 171W00000X
- License
- WA00009587 (WA)
- Practice address
- 26405 103Rd Ave SE
Kent, WA 98030-7026 - Phone
- (253) 921-5875
- NPI assigned
- Apr 2, 2007
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| WA00009587 | WA | MD | Contractor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Contractor | 171W00000X | WA00009587 | WA | Yes |
Addresses
Primary practice location
26405 103Rd Ave SE
Kent, WA 98030-7026
Mailing address
26405 103Rd Ave SE
Kent, WA 98030-7026
Phone (253) 921-5875
Other providers in Kent, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.