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Individual

MRS. CARMON JEAN WALLER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
CPM

Contact information

Practice address
4814 BEACH DR SW, SEATTLE, WA 98116-4343
(206) 963-1028
Mailing address
4814 BEACH DR SW, SEATTLE, WA 98116-4343
(206) 963-1028

Taxonomy

Speciality
Code
Description
License number
State
176B00000X
Midwife
Primary

Other

Enumeration date
07/05/2013
Last updated
07/05/2013
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