Provider Demographics
NPI:1083596969
Name:HALE, JENNIFER EDITH
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:EDITH
Last Name:HALE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4841 AUTO CENTER WAY STE 101
Mailing Address - Street 2:
Mailing Address - City:BREMERTON
Mailing Address - State:WA
Mailing Address - Zip Code:98312-4388
Mailing Address - Country:US
Mailing Address - Phone:360-373-1529
Mailing Address - Fax:
Practice Address - Street 1:2834 CLARE AVE
Practice Address - Street 2:
Practice Address - City:BREMERTON
Practice Address - State:WA
Practice Address - Zip Code:98310-2643
Practice Address - Country:US
Practice Address - Phone:360-373-1529
Practice Address - Fax:360-373-1529
Is Sole Proprietor?:No
Enumeration Date:2025-07-22
Last Update Date:2025-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA175T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist