Individual
LACEY M BLISS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
23213 PACIFIC HWY S, KENT, WA 98032-2721
(206) 870-8880
(206) 520-1499
Mailing address
PO BOX 50095, SEATTLE, WA 98145-5095
(206) 543-6420
(206) 520-5620
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
AP60277066
WA
363LF0000X
Family Nurse Practitioner
AP60277066
WA
Other
Enumeration date
05/08/2012
Last updated
05/08/2012
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