Individual
BRUCE RANDALL LANUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RN, MN, CS, FNP
Contact information
Practice address
4401 BRIDGEPORT WAY W, ATTN CREDENTIALING, UNIVERSITY PLACE, WA 98466-4201
(253) 564-4157
(253) 564-4813
Mailing address
4401 BRIDGEPORT WAY W, ATTN CREDENTIALING, UNIVERSITY PLACE, WA 98466-4201
(253) 564-4157
(253) 564-4813
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
AP60060142
WA
Other
Enumeration date
10/11/2006
Last updated
02/04/2016
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