Individual
MRS. BROOKE OLIVIA ORTH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3709 APOLLO ST SE, LACEY, WA 98503-7137
(360) 556-4456
Mailing address
3709 APOLLO ST SE, LACEY, WA 98503-7137
(360) 556-4456
Taxonomy
Speciality
Code
Description
License number
State
175M00000X
Lay Midwife
Primary
602573980
WA
Other
Enumeration date
12/08/2009
Last updated
12/08/2009
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