Provider Demographics
NPI:1285062752
Name:LOVETT, JILL WREN (MED)
Entity type:Individual
Prefix:
First Name:JILL
Middle Name:WREN
Last Name:LOVETT
Suffix:
Gender:F
Credentials:MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3800 BYRON AVE
Mailing Address - Street 2:
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98229-6506
Mailing Address - Country:US
Mailing Address - Phone:208-597-1869
Mailing Address - Fax:
Practice Address - Street 1:3800 BYRON AVE
Practice Address - Street 2:
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98229-6506
Practice Address - Country:US
Practice Address - Phone:208-597-1869
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-10-21
Last Update Date:2013-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst