Individual
SUSANNE LAKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2500 W SIMS WAY STE 300, PORT TOWNSEND, WA 98368-2234
(360) 385-0610
Mailing address
2500 W SIMS WAY STE 300, PORT TOWNSEND, WA 98368-2234
(360) 385-0610
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
NC10065743
WA
Other
Enumeration date
12/28/2023
Last updated
12/28/2023
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