Organization
LICE CLINICS OF AMERICA BELLEVUE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TRACI LEIGH BENSON (OWNER)
(206) 719-2644
Entity
Organization
Contact information
Practice address
1420 156TH AVE NE STE L, BELLEVUE, WA 98007-4421
(206) 719-2644
Mailing address
1504 184TH AVE NE, BELLEVUE, WA 98008-3303
(206) 719-2644
Taxonomy
Speciality
Code
Description
License number
State
247200000X
Other Technician
Primary
—
—
Other
Enumeration date
04/27/2017
Last updated
04/27/2017
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