Individual
BONNIE DIANNE SIMMONS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
L.M.P.
Contact information
Practice address
8811 WALLER RD E, TACOMA, WA 98446-2527
(253) 389-0938
Mailing address
8811 WALLER RD E, TACOMA, WA 98446-2527
(253) 389-0938
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MA 60189756
WA
Other
Enumeration date
11/09/2010
Last updated
11/09/2010
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