Individual
CAROLYN M GREEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1247 FITZ HUGH DR SE, OLYMPIA, WA 98513-7736
(360) 561-0137
Mailing address
1247 FITZ HUGH DR SE, OLYMPIA, WA 98513-7736
(360) 561-0137
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
751148
WA
Other
Enumeration date
07/07/2014
Last updated
07/07/2014
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