Individual
LAUREL A BOULDS-FISK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMP
Contact information
Practice address
1755 NE 48TH ST, RENTON, WA 98056-9012
(206) 679-4832
Mailing address
7030 121ST PL SE, NEWCASTLE, WA 98056-1202
(425) 687-6933
(425) 687-6933
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MA00007762
WA
Other
Enumeration date
05/01/2007
Last updated
07/08/2007
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