Individual
MR. PAUL FAILLACE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
10510 GRAVELLY LAKE DR SW, LAKEWOOD, WA 98499-5036
(253) 589-7030
Mailing address
8803 ROSE RD SW, LAKEWOOD, WA 98498-1013
(253) 590-3597
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN60695054
WA
Other
Enumeration date
03/28/2023
Last updated
03/28/2023
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