Individual
ASHLEY WINES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
21015 54TH AVENUE CT E, SPANAWAY, WA 98387-4757
(253) 905-9371
Mailing address
21015 54TH AVENUE CT E, SPANAWAY, WA 98387-4757
(360) 825-6525
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LP60596072
WA
Other
Enumeration date
01/25/2016
Last updated
01/25/2016
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