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Individual

BRIANNA MARIE PRUTZ

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
903 MAIN ST, VANCOUVER, WA 98660-3135
(360) 936-2238
Mailing address
7510 NE 34TH AVE, #7, VANCOUVER, WA 98665-8136
(360) 936-2238

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MA00025222
WA

Other

Enumeration date
04/19/2012
Last updated
12/01/2014
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