Individual
KRYSTIE L ROTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
1240 SMITH ST SE, OLYMPIA, WA 98501-2731
(253) 906-0381
Mailing address
1240 SMITH ST SE, OLYMPIA, WA 98501-2731
(253) 906-0381
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LP61354227
WA
Other
Enumeration date
08/22/2023
Last updated
08/22/2023
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