Individual
MS. JACQUELINE A FRADY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMP
Contact information
Practice address
603 HUNT AVE STE B, SUMNER, WA 98390-1117
(253) 209-2137
Mailing address
6420 195TH AVE E, BONNEY LAKE, WA 98391-8858
(253) 209-2137
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MA00009366
WA
Other
Enumeration date
03/08/2006
Last updated
03/22/2014
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