Individual
MICHELLE MASK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
33330 8TH AVE S, FEDERAL WAY, WA 98003-6325
(253) 945-2000
Mailing address
PO BOX 27414, FEDERAL WAY, WA 98093-4414
(253) 331-3446
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LP60764869
WA
Other
Enumeration date
09/16/2022
Last updated
09/16/2022
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