Healthcare Provider Details

I. General information

NPI: 1780914390
Provider Name (Legal Business Name): JEANNE REDLIN LOWE RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/04/2010
Last Update Date: 10/13/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

325 9TH AVE BOX 359731
SEATTLE WA
98104-2420
US

IV. Provider business mailing address

325 9TH AVE BOX 359731
SEATTLE WA
98104-2420
US

V. Phone/Fax

Practice location:
  • Phone: 206-744-1894
  • Fax:
Mailing address:
  • Phone: 206-744-1894
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WW0000X
TaxonomyWound Care Registered Nurse
License NumberRN00111142
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: