Individual
MOLLY LYN SPRAGUE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA60042872
Contact information
Practice address
5501 NE 109TH CT STE L, VANCOUVER, WA 98662
(541) 905-9112
Mailing address
9803 NE 59TH ST, VANCOUVER, WA 98662
(541) 905-9112
Taxonomy
Speciality
Code
Description
License number
State
172M00000X
Mechanotherapist
Primary
MA60042872
WA
Other
Enumeration date
09/19/2012
Last updated
09/19/2012
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