Individual
MIRANDA JANE HALLBERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMP
Contact information
Practice address
610 N MISSION ST STE C4, WENATCHEE, WA 98801-6612
(509) 662-4711
(509) 662-2800
Mailing address
610 N MISSION ST STE C4, WENATCHEE, WA 98801-6612
(509) 662-4711
(509) 662-2800
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MA00023029
WA
Other
Enumeration date
01/11/2007
Last updated
07/08/2007
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