Individual
AUTUMN N LUNDGREN
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
LMP
Contact information
Practice address
3912 10TH ST SE, #101, PUYALLUP, WA 98374-2188
(253) 848-4700
(253) 848-2284
Mailing address
PO BOX 731269, PUYALLUP, WA 98373-0060
(253) 840-2313
(253) 840-6340
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MA00021245
WA
Other
Enumeration date
11/09/2005
Last updated
07/08/2007
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