Individual
EBONY T PEREZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
9500 FRONT ST S, LAKEWOOD, WA 98499-9415
(253) 584-3996
Mailing address
9500 FRONT ST S, LAKEWOOD, WA 98499-9415
(253) 584-3996
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LP60402199
WA
Other
Enumeration date
02/08/2020
Last updated
02/08/2020
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