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Individual

MS. STEFANEE ROSE VENABLE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LMP

Contact information

Practice address
1820 BLACK LAKE BLVD SW STE 103, OLYMPIA, WA 98512-5619
(360) 943-7665
(360) 357-4880
Mailing address
PO BOX 4031, TUMWATER, WA 98501-0031
(360) 943-7665
(360) 357-4880

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MA00013243
WA

Other

Enumeration date
01/16/2007
Last updated
07/08/2007
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