Individual
LEOTA LYNN GIBSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4642 S 282ND ST, AUBURN, WA 98001-1110
(206) 818-9863
Mailing address
4642 S 282ND ST, AUBURN, WA 98001-1110
(206) 818-9863
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
OT 00002387
WA
Other
Enumeration date
11/23/2013
Last updated
11/23/2013
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