Individual provider · NPI-1

Jelina Ip, ND

Family Medicine · Tempe, AZ

NPI number1164824900

StatusActive

Last updated in NPPESNov 4, 2015

Details

NPI: 1164824900
Entity type: Individual (NPI-1)
Name: Jelina Ip
Credential: ND
Sex: Female
Sole proprietor: Yes
Enumeration date: Sep 24, 2014
Last updated: Nov 4, 2015

Taxonomy and licenses

Taxonomy code	Description	License	State	Primary
207Q00000X	Family Medicine	NT60601419	WA	Yes
174N00000X	Lactation Consultant, Non-RN	–	–
374J00000X	Doula	–	–
374K00000X	Religious Nonmedical Practitioner	–	–
175F00000X	Naturopath	NT60601419	WA

Practice location

2050 S Cottonwood Dr
Tempe, AZ 85282-3014

Phone 480-704-4540

Mailing address

2050 S Cottonwood Dr
Tempe, AZ 85282-3014

Phone 480-704-4540

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