Individual
LUCIENE TEIXEIRA CALLON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
288 MARTIN ST, BLAINE, WA 98230-4045
(360) 788-4228
(360) 788-1423
Mailing address
288 MARTIN ST # 1, BLAINE, WA 98230-4045
(360) 788-4228
(360) 778-1423
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
05/08/2024
Last updated
05/08/2024
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