Individual
LAURA LACKEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
16521 13TH AVE W STE 108, LYNNWOOD, WA 98037-8530
(520) 260-4066
Mailing address
1009 135TH AVE SE, SNOHOMISH, WA 98290-5646
(520) 260-4066
Taxonomy
Speciality
Code
Description
License number
State
172M00000X
Mechanotherapist
Primary
MA60487464
WA
Other
Enumeration date
08/20/2014
Last updated
08/20/2014
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