Provider Demographics
NPI:1386961266
Name:MORFORD, JENNIFER NOVA (LPN)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:NOVA
Last Name:MORFORD
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16823 35TH AVE S
Mailing Address - Street 2:
Mailing Address - City:SEATAC
Mailing Address - State:WA
Mailing Address - Zip Code:98188-3142
Mailing Address - Country:US
Mailing Address - Phone:206-919-9972
Mailing Address - Fax:
Practice Address - Street 1:16823 35TH AVE S
Practice Address - Street 2:
Practice Address - City:SEATAC
Practice Address - State:WA
Practice Address - Zip Code:98188-3142
Practice Address - Country:US
Practice Address - Phone:206-919-9972
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-30
Last Update Date:2010-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA 00024180174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist