Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
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Active OrganizationPoint of Service · LACEY, WA
Registration Details
- NPI Number
- 1063617967
- Provider Type
- Organization
- NPI Issued
- Jun 19, 2007 (18.840690607908 yrs)
- Last Updated
- Jun 30, 2008
- License
-
OP00001758 (WA)
Practice Information
- Address
-
130 MARVIN RD SE STE 112LACEY, WA, 985036101Browse WA providers · Browse ZIP 98503
- Phone
- 3609231111
- Fax
- 3604558677
- Primary Specialty
-
Point of Service
305S00000X
Data sourced from the NPPES National Provider Identifier registry. Healthcare organizations registered in NPPES are assigned an NPI number for use in insurance billing and claims. This information is for informational purposes only. For official verification, use the NPPES NPI Registry.