Individual
LAUREN CHRISTINE DIFOLCO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
10920 199TH AVE. CT. E., BONNEY LAKE HS,, BONNEY LAKE, WA 98391
(253) 891-5700
Mailing address
1221 MOTTMAN RD SW APT D203, TUMWATER, WA 98512-6391
(720) 425-4641
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
516288H
WA
Other
Enumeration date
08/19/2015
Last updated
08/19/2015
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