Provider Demographics
NPI:1447487459
Name:STANKUS, JENNIFER LH (MD)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:LH
Last Name:STANKUS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9040 JACKSON AVENUE MADIGAN ARMY MEDICAL CENTER
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98431-1017
Mailing Address - Country:US
Mailing Address - Phone:253-698-1390
Mailing Address - Fax:
Practice Address - Street 1:9040 JACKSON AVENUE MADIGAN ARMY MEDICAL CENTER
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98431-1017
Practice Address - Country:US
Practice Address - Phone:253-698-1390
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-17
Last Update Date:2020-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXR3965207P00000X
WAMD60288086207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine