Individual
SARA GANTZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
12704 SE 318TH WAY, AUBURN, WA 98092-3672
(206) 234-4159
Mailing address
12704 SE 318TH WAY, AUBURN, WA 98092-3672
(206) 234-4159
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LP60067724
WA
Other
Enumeration date
12/13/2013
Last updated
12/13/2013
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