Individual
MS. CARMEN MAXWELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
815 S PEARL ST, TACOMA, WA 98465-2117
(253) 396-5930
Mailing address
815 S PEARL ST, TACOMA, WA 98465-2117
(253) 396-5930
Taxonomy
Speciality
Code
Description
License number
State
283Q00000X
Psychiatric Hospital
Primary
LP00020939
WA
Other
Enumeration date
11/17/2007
Last updated
11/17/2007
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