Individual
SERENA LACOUR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
7614 195TH ST SW STE 101, EDMONDS, WA 98026-6260
(425) 775-4059
Mailing address
20126 BALLINGER WAY NE # 290, SHORELINE, WA 98155-1117
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1265520183
—
CA
05
—
1306922554
—
CA
05
—
1841342318
—
CA
Enumeration date
02/26/2007
Last updated
03/27/2019
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