Individual
ERIC GARDNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1202 BLACK LAKE BLVD SW, OLYMPIA, WA 98502-7207
(360) 878-8248
(360) 489-0402
Mailing address
628 I ST SW, TUMWATER, WA 98512-6872
(513) 546-2892
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
04/18/2022
Last updated
04/18/2022
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