Individual
ASHLEY MAE GROSSO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
7011 S I ST, TACOMA, WA 98408
(253) 282-9858
Mailing address
7011 S I ST, TACOMA, WA 98408-4412
(253) 282-9858
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LP60447577
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
164W00000X
—
WA
Enumeration date
09/16/2016
Last updated
09/16/2016
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