Individual
MRS. MELINDA GAYLE BOONSTRA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4308 76TH ST NE, MARYSVILLE, WA 98270-3720
(425) 349-7352
Mailing address
PO BOX 3810, EVERETT, WA 98213
(425) 349-8359
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
—
—
1041C0700X
Clinical Social Worker
Primary
LW61279465
WA
Other
Enumeration date
09/17/2012
Last updated
08/11/2022
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