Individual
VICKI LANE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
24423 100TH AVE SE, KENT, WA 98030-4846
(253) 812-2096
Mailing address
PO BOX 6057, KENT, WA 98064-6057
Taxonomy
Speciality
Code
Description
License number
State
374T00000X
Religious Nonmedical Nursing Personnel
Primary
—
—
376G00000X
Nursing Home Administrator
—
—
Other
Enumeration date
08/31/2012
Last updated
08/31/2012
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