Individual
MS. LORI L DEALY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
EAST 100 SOUTH, SALT LAKE CITY, UT 84102-2965
(123) 456-7890
Mailing address
2325 NW 97TH ST, SEATTLE, WA 98117-2552
(206) 437-3220
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
AP30006412
WA
Other
Enumeration date
01/08/2007
Last updated
09/03/2020
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