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Individual

TONYA NICHOLE DESPAIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LMP

Contact information

Practice address
16303 HIGHWAY 99 STE 2B, LYNNWOOD, WA 98087-1453
(425) 242-4884
Mailing address
19625 73RD AVE W, LYNNWOOD, WA 98036-5803
(425) 244-8883

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
60331549
WI

Other

Enumeration date
03/30/2013
Last updated
03/30/2013
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