Individual
LAISA MILAGROS LEON HIDALGO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
13410 HIGHWAY 99 STE 204, EVERETT, WA 98204-5454
(425) 742-7300
Mailing address
PO BOX 504, MARYSVILLE, WA 98270-0504
(425) 268-5600
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
60933077
WA
Other
Enumeration date
11/30/2020
Last updated
11/30/2020
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