Healthcare Provider Details

I. General information

NPI: 1639000995
Provider Name (Legal Business Name): JENNA ROUND
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/26/2026
Last Update Date: 05/26/2026
Certification Date: 05/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5323 W BISMARK AVE
SPOKANE WA
99208-6296
US

IV. Provider business mailing address

5323 W BISMARK AVE
SPOKANE WA
99208-6296
US

V. Phone/Fax

Practice location:
  • Phone: 509-570-2705
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code376K00000X
TaxonomyNurse's Aide
License Number425337
License Number StateMT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: