Individual
MARY BRUCKELMYER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
31707 NE PARCEL AVE, YACOLT, WA 98675-3456
(360) 686-3845
Mailing address
PO BOX 851, YACOLT, WA 98675-0900
(360) 686-3845
Taxonomy
Speciality
Code
Description
License number
State
374J00000X
Doula
Primary
—
—
Other
Enumeration date
04/30/2013
Last updated
04/30/2013
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