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Individual

MS. SUNNY M GAUT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LMP

Contact information

Practice address
114 W WALNUT ST, CENTRALIA, WA 98531-4021
(360) 701-3642
Mailing address
1406 SW KELLY AVE, CHEHALIS, WA 98532-3719
(360) 701-3642
(360) 748-8651

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MA00025123
WA

Other

Enumeration date
01/04/2008
Last updated
01/04/2008
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