Individual
REBECCA ELMORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4012 N 24TH ST, TACOMA, WA 98406-4805
(206) 459-0972
Mailing address
4012 N 24TH ST, TACOMA, WA 98406-4805
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
0000000861
WA
Other
Enumeration date
11/15/2012
Last updated
11/15/2012
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