Individual
STACY PENNY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
5548 MYRTLE AVE STE 202, FREELAND, WA 98249-8776
(360) 914-2068
Mailing address
7019 HIGH MEADOW DR, CLINTON, WA 98236-8701
(360) 914-2068
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MA00022531
WA
Other
Enumeration date
11/21/2007
Last updated
12/11/2025
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