Individual
MICHAELA DEBONO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMP
Contact information
Practice address
509 CUSTER WAY SE, TUMWATER, WA 98501-3332
(360) 489-0635
(360) 489-0917
Mailing address
3401 HAWTHORNE PL SE, TUMWATER, WA 98501-3597
(360) 556-0656
(360) 489-0917
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MA60197264
WA
Other
Enumeration date
02/09/2011
Last updated
02/09/2011
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