Individual
CHEYANNA MAE CARLSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMP
Contact information
Practice address
14700 NE 8TH ST, #115, BELLEVUE, WA 98007-4115
(425) 644-8386
Mailing address
15026 40TH AVE W, 4-302, LYNNWOOD, WA 98087-8952
(619) 818-7659
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MA 60230431
WA
Other
Enumeration date
07/19/2011
Last updated
07/19/2011
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