Individual
CONRAD SLATER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCO
Contact information
Practice address
3508 12TH AVE NE, OLYMPIA, WA 98506-5218
(360) 459-1099
Mailing address
252 BROADWAY APT 510, TACOMA, WA 98402-4003
(540) 931-8478
Taxonomy
Speciality
Code
Description
License number
State
222Z00000X
Orthotist
Primary
61272281
WA
Other
Enumeration date
08/03/2022
Last updated
08/03/2022
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