Healthcare Provider Details

I. General information

NPI: 1326857764
Provider Name (Legal Business Name): JILLIAN HARRINGTON PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: JILLIAN LOTTRIDGE PHD

II. Dates (important events)

Enumeration Date: 12/31/2024
Last Update Date: 12/31/2024
Certification Date: 12/31/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1457 E MEADOW BLUFF LN
DRAPER UT
84020-5598
US

IV. Provider business mailing address

1457 E MEADOW BLUFF LN
DRAPER UT
84020-5598
US

V. Phone/Fax

Practice location:
  • Phone: 541-914-7562
  • Fax:
Mailing address:
  • Phone: 541-914-7562
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code247ZC0005X
TaxonomyClinical Laboratory Director (Non-physician)
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: