Individual
STACIA LEE DESHON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
BLACKFEET COMMUNITY HOSPITAL, 760 HOSPITAL CIRCLE, BROWNING, MT 59417-0760
(406) 338-6369
Mailing address
8516 WILLOWOOD CIR SW, LAKEWOOD, WA 98498-4471
(406) 338-6369
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
00099859
WA
Other
Enumeration date
06/06/2007
Last updated
07/08/2007
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