Individual
SALLY LYNNETTE HUMPHRIES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
1622 NE 9TH AVE, OAK HARBOR, WA 98277-4360
(971) 940-9499
Mailing address
1622 NE 9TH AVE, OAK HARBOR, WA 98277-4360
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LP00055742
WA
Other
Enumeration date
06/27/2024
Last updated
06/27/2024
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