Individual
CIERRA LYNN BRUNETTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
17425 WA-99, SUITE D, LYNNWOOD, WA 98037
(425) 329-7259
Mailing address
12402 ADMIRALTY WAY APT I301, EVERETT, WA 98204-8583
(425) 299-8240
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D160817731
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
D160817731
—
WA
Enumeration date
08/02/2018
Last updated
08/02/2018
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