Individual
LEO THOMAS CASTONGUAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPN
Contact information
Practice address
3629 S D ST, TACOMA, WA 98418-6813
(253) 798-6576
Mailing address
3629 S D ST, TACOMA, WA 98418-6813
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LP00055981
WA
Other
Enumeration date
07/19/2018
Last updated
07/19/2018
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