Individual
LEATOA CHARLONNE AFUOLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
9720 S TACOMA WAY, TACOMA, WA 98499-4456
(253) 503-3666
Mailing address
9720 S TACOMA WAY, TACOMA, WA 98499-4456
(253) 503-3666
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LP60598611
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2001900
—
WA
Enumeration date
08/15/2018
Last updated
08/15/2018
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