Individual
DIANE LEE TRACY-SHIER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
11120 GRAVELLY LAKE DR SW STE 3, LAKEWOOD, WA 98499-1350
(253) 582-4328
Mailing address
12816 133RD AVE E, PUYALLUP, WA 98374-4855
(253) 845-6688
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MA00006950
WA
Other
Enumeration date
04/18/2007
Last updated
07/08/2007
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