Individual
LYDIA ROSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
901 MOUNTAIN VIEW DR, SHELTON, WA 98584-4401
(360) 426-1611
Mailing address
PO BOX 1668, SHELTON, WA 98584-5001
(604) 279-5493
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
MD61571715
WA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/13/2022
Last updated
07/03/2025
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