Individual
SUMMER MICAIAH ST CHRISTOPHER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCMT
Contact information
Practice address
1045 JADWIN AVE, SUITE C, RICHLAND, WA 99352-3405
(301) 802-4010
Mailing address
7803 W DESCHUTES AVE, #D-114, KENNEWICK, WA 99336-1686
(301) 802-4010
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MA60183784
WA
Other
Enumeration date
10/28/2010
Last updated
10/28/2010
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