Individual
MRS. KRISTIE ANN LACKEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
7101 NE 137TH AVE, VANCOUVER, WA 98682-4933
(360) 944-4998
Mailing address
7101 NE 137TH AVE, VANCOUVER, WA 98682-4933
(360) 944-4998
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
7841
OR
Other
Enumeration date
09/16/2008
Last updated
09/16/2008
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