Individual
STANLEY CONKLIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPN
Contact information
Practice address
19905 97TH AVENUE CT E, GRAHAM, WA 98338-4800
(210) 569-2103
Mailing address
19905 97TH AVENUE CT E, GRAHAM, WA 98338-4800
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LP60485197
WA
Other
Enumeration date
10/26/2023
Last updated
10/26/2023
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