Healthcare Provider Details

I. General information

NPI: 1407120611
Provider Name (Legal Business Name): JOYCE HESS C. PED.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/06/2012
Last Update Date: 03/06/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

208 LILLY RD NE SUITE A
OLYMPIA WA
98506-6100
US

IV. Provider business mailing address

13017B VAIL CUT OFF RD SE
RAINIER WA
98576-9679
US

V. Phone/Fax

Practice location:
  • Phone: 360-459-1099
  • Fax: 360-459-1794
Mailing address:
  • Phone: 858-837-0959
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code224L00000X
TaxonomyPedorthist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: