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Individual

MRS. SAMANTHA LEAH SIMON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MA-C

Contact information

Practice address
401 S 25TH ST, MOUNT VERNON, WA 98274-4772
(360) 399-3611
Mailing address
401 S 25TH ST, MOUNT VERNON, WA 98274-4772
(360) 399-3611

Taxonomy

Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
911180810
WA

Other

Enumeration date
12/31/2018
Last updated
12/31/2018
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