Individual
LEAH REIKO NYSTROM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
413 MORRIS ST, LA CONNER, WA 98257
(360) 466-7458
Mailing address
11106 WHISTLE LAKE RD, ANACORTES, WA 98221-4388
(360) 293-5735
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT00005426
WA
Other
Enumeration date
08/30/2019
Last updated
08/30/2019
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