Individual
MICHAEL WESLEY FISH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPN
Contact information
Practice address
8408 133RD ST E, PUYALLUP, WA 98373-2596
(253) 335-9438
Mailing address
8408 133RD ST E, PUYALLUP, WA 98373-2596
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
226437
TX
Other
Enumeration date
05/17/2010
Last updated
05/17/2010
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