Individual
MRS. LAURA FLICK LEWIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.
Contact information
Practice address
9040 JACKSON AVE, TACOMA, WA 98431-8660
(253) 968-1790
Mailing address
404 YAUGER WAY SW, SUITE 100, OLYMPIA, WA 98502-8660
(360) 786-8990
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
PA10004699
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8479867
—
WA
Enumeration date
06/17/2006
Last updated
10/23/2019
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