Individual
STACEY L HART
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
P.T.A.
Contact information
Practice address
24216 WITTE RD SE, MAPLE VALLEY, WA 98038-6827
(425) 433-3500
Mailing address
24216 WITTE RD SE, MAPLE VALLEY, WA 98038-6827
(425) 433-3500
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
P1 60042716
WA
Other
Enumeration date
09/27/2012
Last updated
09/27/2012
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