Individual
LAZIA VAN WIERINGEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2320 FREEWAY DR, MOUNT VERNON, WA 98273-5445
(360) 428-2550
(360) 428-6402
Mailing address
910 GLADSTONE ST APT 111, BELLINGHAM, WA 98229-6226
(425) 367-9015
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
PA.PA.61187952
WA
363AM0700X
Medical Physician Assistant
Primary
PA61187952
WA
Other
Enumeration date
05/02/2020
Last updated
12/30/2024
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