MEDICARE: JEANENE LYNN FRICKEL

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	374J00000X	Doula		WA

General Provider Information

NPI Number	:	1548103278
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JEANENE LYNN FRICKEL

Provider Business Mailing Address
First Line	:	74 MILES RD
Second Line	:
City	:	PORT ANGELES
State	:	WA
Zip	:	98362-9233
Country	:	US
Telephone Number	:	360-775-6028
Fax Number	:	360-775-6028

Provider Business Practice Location Address
First Line	:	74 MILES RD
Second Line	:
City	:	PORT ANGELES
State	:	WA
Zip	:	98362-9233
Country	:	US
Telephone Number	:	360-775-6028
Fax Number	:	360-775-6028

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

Provider Enumeration Date	:	04/09/2026
Last Update Date	:	04/09/2026

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Directions to “ JEANENE LYNN FRICKEL ” Practice Location

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