Individual
CHAMPA EANES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
9040 JACKSON AVE, TACOMA, WA 98433
(253) 968-0842
Mailing address
2218 BOBS HOLLOW LN, DUPONT, WA 98327-8788
(503) 309-7710
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LP60209757
WA
Other
Enumeration date
05/10/2016
Last updated
05/10/2016
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