Individual
MRS. CRYSTAL BELLE PHIPPS BLOOMFELDT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
214 AUTUMN HILLS RD, KELSO, WA 98626-9018
(360) 355-7658
Mailing address
214 AUTUMN HILLS RD, KELSO, WA 98626-9018
(360) 355-7658
Taxonomy
Speciality
Code
Description
License number
State
1710I1002X
Independent Duty Corpsman
Primary
—
—
Other
Enumeration date
06/26/2019
Last updated
06/26/2019
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