Individual
MARY JANE L LACIST
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3950 KEENE RD, WEST RICHLAND, WA 99353-4901
(206) 412-5712
Mailing address
3950 KEENE RD, WEST RICHLAND, WA 99353-4901
(206) 412-5712
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
61050405
WA
Other
Enumeration date
06/15/2020
Last updated
06/15/2020
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