Individual
AMPHONE PHOUMMANY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2201 S 19TH ST, TACOMA, WA 98405-2962
(253) 301-5237
Mailing address
929 133RD ST S, PARKLAND, WA 98444-3509
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
09/15/2021
Last updated
09/15/2021
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