Most Relevant Information
Provider Data
| NPI Number: | 1003023300 |
| Provider Name: | JOLEEN ANNE MOLLENBERG EMT-B |
| Entity Type: | Individual |
| Taxonomy Code: | 146N00000X |
| Specialty: | Emergency Medical Technician, Basic |
| License Number: | 0119015 |
Most Important Dates
| Enumeration Date: | 05/17/2007 |
| Last Updated: | 07/09/2007 |
Provider Practice Location
1 COLVILLE STREET
NESPELEM
WA
99155
Practice Location Phone/Fax
| Phone: | 5096342727 |
| Fax: | 5096342781 |
Provider Mailing Location
1 COLVILLE STREET
NESPELEM
WA
99155
Provider Mailing Phone/Fax
| Phone: | 5096342727 |
| Fax: | 5096342781 |