Individual
LICA IWASAKI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3901 HOYT AVE, EVERETT, WA 98201-4918
(425) 339-5468
Mailing address
3901 HOYT AVE, EVERETT, WA 98201-4918
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
AP30007106
WA
Other
Enumeration date
11/08/2006
Last updated
07/08/2007
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