Individual
CHERIE DOMINGUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1800 7 OAKS RD SE, LACEY, WA 98503-7300
(360) 412-4703
Mailing address
824 ANTHONY CT SW, TUMWATER, WA 98512-6367
(360) 412-4703
Taxonomy
Speciality
Code
Description
License number
State
163WS0200X
School Registered Nurse
Primary
RN00121671
WA
Other
Enumeration date
05/20/2014
Last updated
05/20/2014
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