Individual
MELISSA JO TETREAULT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
303 91ST AVE NE, SUITE E504, EVERETT, WA 98205-1541
(425) 334-6258
(425) 334-1187
Mailing address
11009 69TH ST NE, LAKE STEVENS, WA 98258-2047
(425) 334-6258
(425) 334-1187
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MA00017810
WA
Other
Enumeration date
02/05/2007
Last updated
07/08/2007
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