Individual
MS. TAMMY LYNNE GAGNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S.
Contact information
Practice address
8425 40TH ST W, UNIVERSITY PLACE, WA 98466-2041
(253) 651-0932
Mailing address
9426 187TH STREET CT E, PUYALLUP, WA 98375-6222
(253) 651-0932
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
282162R
WA
Other
Enumeration date
03/07/2014
Last updated
03/07/2014
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