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General NPI Number Information
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NPI Number | 1902672553
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Entity Type | Individual
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Provider Name | JESSICA ELIZABETH HALE
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Gender | Female
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Dates
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Enumeration Date | 11/27/2023
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Last Update Date | 07/23/2025
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Provider Practice Location Address
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Address Line | 180 1ST ST S STE 9
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City | FRIDAY HARBOR
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State | WA
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Zip | 98250-8324
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Country | US
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Telephone | 360-378-4913
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 459
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City | FRIDAY HARBOR
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State | WA
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Zip | 98250-0459
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Country | US
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Telephone | 360-378-4913
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 70004996
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License Number State | WA
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