Individual
VANESSA G BUSH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
9618 GRAVELLY LAKE DR SW, #201, LAKEWOOD, WA 98499-1575
(253) 777-2321
Mailing address
3232 94TH ST S, #6, LAKEWOOD, WA 98499-9322
(253) 777-2321
Taxonomy
Speciality
Code
Description
License number
State
247200000X
Other Technician
Primary
0025013
WA
Other
Enumeration date
09/28/2009
Last updated
10/01/2009
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