MEDICARE: MISS JOANNE F WRIGHT LMP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208D00000X	General Practice Physician	MA00004548	WA

General Provider Information

NPI Number	:	1063541555
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISS JOANNE F WRIGHT LMP

Provider Business Mailing Address
First Line	:	PO BOX 578
Second Line	:
City	:	PORT ORCHARD
State	:	WA
Zip	:	98366-0578
Country	:	US
Telephone Number	:	360-731-3151
Fax Number	:

Provider Business Practice Location Address
First Line	:	1008 BETHEL AVE STE A
Second Line	:
City	:	PORT ORCHARD
State	:	WA
Zip	:	98366-4236
Country	:	US
Telephone Number	:	360-895-7744
Fax Number	:	360-895-1166

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/02/2007
Last Update Date	:	07/08/2007

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