Individual
BERTHA MAE BANKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
925 NE OPAL CT, BREMERTON, WA 98311-8760
(203) 470-9886
Mailing address
925 NE OPAL CT, BREMERTON, WA 98311-8760
(203) 470-9886
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LP60317368
WA
Other
Enumeration date
01/09/2020
Last updated
01/09/2020
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