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Individual

ELIZABETH LOUISE BERQUEST

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LPN

Contact information

Practice address
4012 WIGGINS RD SE, OLYMPIA, WA 98501-4372
(360) 491-1036
(360) 491-1416
Mailing address
511 CHOKER ST SE, LACEY, WA 98503-1532
(360) 970-3181

Taxonomy

Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
60835975
WA

Other

Enumeration date
06/19/2018
Last updated
06/19/2018
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