Individual
ANNA RAE DEGRAFFENREID
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
17395 RESERVATION RD, LA CONNER, WA 98257-8802
(360) 920-7061
Mailing address
17395 RESERVATION RD, LA CONNER, WA 98257-8802
(360) 920-7061
Taxonomy
Speciality
Code
Description
License number
State
125J00000X
Dental Therapist
Primary
21-TDT-01
WA
Other
Enumeration date
04/19/2022
Last updated
04/21/2022
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