Individual
MIFAWNWY CARLSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
L.M.
Contact information
Practice address
12270 OLALLA VALLEY RD SE, OLALLA, WA 98359-9748
(253) 857-6359
(253) 857-6359
Mailing address
12270 OLALLA VALLEY RD SE, OLALLA, WA 98359-9748
(253) 857-6359
(253) 857-6359
Taxonomy
Speciality
Code
Description
License number
State
176B00000X
Midwife
Primary
MW00000061
WA
Other
Enumeration date
01/23/2007
Last updated
07/08/2007
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