Individual
MIA NICOLE TREASURE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMP
Contact information
Practice address
2418 NW HAYES RD, WOODLAND, WA 98674-2218
(360) 907-0139
Mailing address
2418 NW HAYES RD, WOODLAND, WA 98674-2218
(360) 907-0139
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
60492977
WA
Other
Enumeration date
12/31/2014
Last updated
12/31/2014
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