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Individual

LISA ELAINE WIRE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
6220 S ALASKA ST, TACOMA, WA 98408-1317
(253) 476-5300
Mailing address
18508 65TH ST E, BONNEY LAKE, WA 98391-8826
(253) 863-5333

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
00001392
WA

Other

Enumeration date
06/06/2008
Last updated
06/06/2008
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