Individual
MS. CARRIE DISTEFANO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
IBCLC
Contact information
Practice address
5125 DEMARIE CT SE, OLYMPIA, WA 98501-5079
(360) 918-2392
Mailing address
5125 DEMARIE CT SE, OLYMPIA, WA 98501-5079
(360) 918-2392
Taxonomy
Speciality
Code
Description
License number
State
174N00000X
Lactation Consultant (Non-RN)
Primary
—
—
Other
Enumeration date
11/04/2015
Last updated
11/04/2015
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