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ABOUBACAR SIDIBE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
LPN

Contact information

Practice address
14016 A ST S, TACOMA, WA 98444-4662
(253) 302-3675
Mailing address
14016 A ST S, TACOMA, WA 98444-4662
(253) 302-3675

Taxonomy

Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LP00058801
WA

Other

Enumeration date
10/12/2011
Last updated
10/12/2011
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