Individual
JAMES M ELVIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LICENSED DENTURIST
Contact information
Practice address
1401 4TH AVE E, OLYMPIA, WA 98506-4484
(360) 456-6040
Mailing address
PO BOX 3221, LACEY, WA 98509-3221
(360) 456-6040
Taxonomy
Speciality
Code
Description
License number
State
122400000X
Denturist
Primary
DN00000292
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5039920
—
WA
Enumeration date
08/12/2007
Last updated
08/12/2007
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