Individual
JOHN MATTHEW LACY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
325 9TH AVE, SEATTLE, WA 98104-2420
(206) 680-1851
Mailing address
PO BOX 50095, SEATTLE, WA 98145-5095
(206) 680-1851
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD00040446
WA
207ZF0201X
Forensic Pathology Physician
MD00040446
WA
Other
Enumeration date
08/15/2008
Last updated
11/01/2010
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