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Individual

LAURA STONE GRUSE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
815 S PEARL ST, TACOMA, WA 98465-2117
(253) 396-5930
Mailing address
1430 S MASON AVE, TACOMA, WA 98405-1114
(253) 752-9804

Taxonomy

Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LP00026271
WA

Other

Enumeration date
09/11/2010
Last updated
09/11/2010
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