Individual
LISA KRAUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMP
Contact information
Practice address
4510 INTELCO LOOP SE STE A, LACEY, WA 98503-6005
(360) 402-6776
Mailing address
7046 FLUTE ST SE, LACEY, WA 98513-5053
(334) 447-8814
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
MA6052126
WA
Other
Enumeration date
08/28/2015
Last updated
08/28/2015
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