Individual
BECKY WALTZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMP
Contact information
Practice address
8401 MAIN ST, EDMONDS, WA 98026-6919
(425) 563-6893
Mailing address
9889 CENTRAL VALLEY RD NW, BREMERTON, WA 98311-9131
(360) 629-1718
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MA60407123
WI
Other
Enumeration date
12/31/2013
Last updated
01/06/2014
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