Individual
MELBA LAZETTE GRANT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1412 140TH PL NE, BELLEVUE, WA 98007-3915
(425) 747-7892
(425) 747-8348
Mailing address
1412 140TH PL NE, BELLEVUE, WA 98007-3915
(425) 747-7892
(425) 747-8348
Taxonomy
Speciality
Code
Description
License number
State
247200000X
Other Technician
Primary
—
—
Other
Enumeration date
11/19/2021
Last updated
11/19/2021
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