Individual
LYDIA MIRIAM LAGROU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6808 220TH ST SW, #203, MOUNTLAKE TERRACE, WA 98043-2187
(425) 776-1056
(425) 412-6274
Mailing address
6808 220TH ST SW, #203, MOUNTLAKE TERRACE, WA 98043-2187
(425) 776-1056
(425) 412-6274
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MA60305875
WA
Other
Enumeration date
04/25/2013
Last updated
04/25/2013
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