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Individual

TRISTAN GEORGE RUNYON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
9514 4TH ST NE UNIT 101, LAKE STEVENS, WA 98258-1937
(425) 397-2327
Mailing address
102 140TH ST NW, TULALIP, WA 98271-6795
(630) 999-5466

Taxonomy

Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
P161362588
WA

Other

Enumeration date
01/30/2023
Last updated
01/30/2023
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