Individual
STARR MARIE TACEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
L.M.P.
Contact information
Practice address
3100 SE MILE HILL DR STE A, PORT ORCHARD, WA 98366-2962
(360) 895-4844
Mailing address
PO BOX 1628, PORT ORCHARD, WA 98366
(360) 895-4844
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
MA60055117
WA
Other
Enumeration date
12/29/2009
Last updated
12/29/2009
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