Individual
KARISSA EBERT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
7056 PORTAL WAY # R-7, FERNDALE, WA 98248-8310
(360) 366-4216
Mailing address
1456 ROMA RD, BELLINGHAM, WA 98226-7890
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MA00024981
WA
Other
Enumeration date
09/11/2008
Last updated
09/11/2008
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