Individual
ANNIE GADDIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1128 BROADWAY ST, LONGVIEW, WA 98632-3831
(360) 261-6930
Mailing address
1820 SUSAN AVE, LONGVIEW, WA 98632-3326
(360) 953-0618
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
08/07/2022
Last updated
06/26/2023
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