Individual
MS. TRACI L FRALIC
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMP
Contact information
Practice address
308 PINE ST, MOUNT VERNON, WA 98273-3852
(360) 873-8643
Mailing address
1500 E COLLEGE WAY STE A, PMB #273, MOUNT VERNON, WA 98273-5637
(360) 873-8643
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MA23658
WA
Other
Enumeration date
05/03/2007
Last updated
11/10/2010
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