Individual
DEBORAH J GILLHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMP, CCST
Contact information
Practice address
4103 BRIDGEPORT WAY W, UNIVERSITY PLACE, WA 98466-4300
(253) 460-1824
(253) 460-1920
Mailing address
24111 122ND ST E, BUCKLEY, WA 98321-9575
(253) 224-8875
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MA00024203
WA
Other
Enumeration date
05/25/2011
Last updated
05/25/2011
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