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Individual

MS. DIANE JEANNE SONNTAG

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LMT

Contact information

Practice address
205 CLARK PL SE, TUMWATER, WA 98501-4062
(360) 264-5521
Mailing address
1527 143 AVE, TENINO, WA 98589
(360) 264-5521

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
60018972
WA

Other

Enumeration date
07/11/2008
Last updated
07/11/2008
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