Individual
MICHELLE LARAE LONGWILL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
201 7TH ST, HOQUIAM, WA 98550-2506
(360) 532-5454
Mailing address
108 BASS AVE NE, OCEAN SHORES, WA 98569-9626
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
00043314
WA
Other
Enumeration date
09/03/2024
Last updated
09/03/2024
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