Individual
MR. BRIAN MATTHEW STOUT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
18306 71ST AVE E, PUYALLUP, WA 98375-1843
(931) 538-2387
Mailing address
18306 71ST AVE E, PUYALLUP, WA 98375-1843
(931) 538-2387
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
LP60534434
WA
Other
Enumeration date
02/01/2021
Last updated
02/01/2021
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