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Individual

MR. PATRICK C. GRANT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LD

Contact information

Practice address
2902 S 74TH ST, TACOMA, WA 98409-5911
(253) 471-9999
(253) 474-2337
Mailing address
2902 S 74TH ST, TACOMA, WA 98409-5911
(253) 471-9999
(253) 474-2337

Taxonomy

Speciality
Code
Description
License number
State
122400000X
Denturist
Primary
DN00000196
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
5025085
WA
Enumeration date
02/17/2010
Last updated
02/18/2010
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