Individual
DEBRA LYNNE CORNWELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1707 COOKS HILL RD, CENTRALIA, WA 98531-9071
(360) 261-6930
Mailing address
PO BOX 255, SILVER CREEK, WA 98585-0255
(360) 949-6578
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
WA
Other
Enumeration date
08/03/2023
Last updated
08/03/2023
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