Individual
MYRIAM MAMPENGU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6103 MOUNT TACOMA DR SW, LAKEWOOD, WA 98499-2727
(253) 263-3221
Mailing address
6103 MOUNT TACOMA DR SW, LAKEWOOD, WA 98499-2727
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
60922600
WA
Other
Enumeration date
01/23/2019
Last updated
01/23/2019
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