Individual
TAYLOR VANWICKLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
165 E. HAWTHORNE AVE, COLVILLE, WA 99114
(509) 684-4597
(509) 684-5286
Mailing address
165 E. HAWTHORNE AVE, COLVILLE, WA 99114
(509) 684-4597
(509) 684-5286
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
NC10069344
WA
Other
Enumeration date
02/06/2018
Last updated
02/06/2018
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