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Individual

STACI LAY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LMP

Contact information

Practice address
21135 SR 410 E, BONNEY LAKE, WA 98391-8457
(253) 740-7829
(360) 879-1115
Mailing address
PO BOX 1701, EATONVILLE, WA 98328-1701
(253) 740-7829
(360) 879-1115

Taxonomy

Speciality
Code
Description
License number
State
175L00000X
Homeopath
Primary
MA00018332
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
601736801
UBI
WA
Enumeration date
11/06/2006
Last updated
07/01/2016
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