Individual
STACY RICCELLI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
19401 40TH AVE W, SUITE 330, LYNNWOOD, WA 98036-4612
(425) 670-9987
Mailing address
19401 40TH AVE W, SUITE 330, LYNNWOOD, WA 98036-4612
(425) 670-9987
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
60043839
WA
Other
Enumeration date
08/07/2013
Last updated
08/07/2013
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