Individual
GAVINA BAH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
37885 CAPE HORN RD, CONCRETE, WA 98237-9233
(425) 678-3336
Mailing address
PO BOX 214, MUKILTEO, WA 98275-0214
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LP00051785
WA
Other
Enumeration date
01/04/2020
Last updated
01/04/2020
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