Individual
MRS. THERESA DEANN O'LEARY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
1601 26TH AVE SE, PUYALLUP, WA 98374-1349
(253) 841-8746
Mailing address
6216 119TH AVE E, PUYALLUP, WA 98372-2825
(253) 268-0808
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LP00059871
WA
Other
Enumeration date
12/04/2012
Last updated
12/04/2012
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