Individual
MISS STEPHANIE JEANMARIE WEDLUND
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
L.M.P.
Contact information
Practice address
27034 SE RAVENSDALE PL, RAVENSDALE, WA 98051-8100
(206) 396-1421
Mailing address
27034 SE RAVENSDALE PL, RAVENSDALE, WA 98051-8100
(206) 396-1421
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MA00014598
WA
Other
Enumeration date
05/21/2007
Last updated
07/08/2007
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