Individual
LESA J BOWLES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMP
Contact information
Practice address
3721 N 27TH ST, TACOMA, WA 98407-5810
(360) 259-0508
Mailing address
3721 N 27TH ST, TACOMA, WA 98407-5810
(360) 259-0508
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MA60253963
WA
Other
Enumeration date
08/20/2012
Last updated
08/20/2012
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