Individual
LORI DODGE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMP
Contact information
Practice address
1736 NE RIDDELL RD STE 103, BREMERTON, WA 98310-3685
(360) 509-5800
(360) 876-6083
Mailing address
PO BOX 2501, BREMERTON, WA 98310-0325
(360) 509-5800
(360) 876-6083
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MA00015829
WA
Other
Enumeration date
11/17/2006
Last updated
07/08/2007
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