Individual
FRANCES ROSE SOUTHALL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMP
Contact information
Practice address
6240 TACOMA MALL BLVD, SUITE 104, TACOMA, WA 98409-6819
(253) 474-3569
Mailing address
6240 TACOMA MALL BLVD, SUITE 104, TACOMA, WA 98409-6819
(253) 474-3569
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MA00014272
WA
Other
Enumeration date
10/28/2008
Last updated
10/28/2008
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