Individual
DR. MAUREEN A LECLAIR-DENTLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
407 14TH AVE SE, PUYALLUP, WA 98372-3770
(253) 848-6661
(253) 770-5990
Mailing address
8803 30TH STREET CT NW, GIG HARBOR, WA 98335-6015
(253) 265-8009
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
MD00028693
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8128068
—
WA
Enumeration date
06/18/2006
Last updated
03/10/2008
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