Individual
DEBI M SELIX
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
L.M.P.
Contact information
Practice address
28610 MAPLE VALLEY BLACK DIAMOND RD SE, SUITE 120, MAPLE VALLEY, WA 98038-8199
(253) 381-4298
Mailing address
PO BOX 1154, MAPLE VALLEY, WA 98038-1154
(253) 381-4298
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MA00007682
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MA00007682
STATE LICENSE LMP
WA
Enumeration date
03/25/2008
Last updated
09/17/2016
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