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Individual

MS. TRACIE BAUMAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LMP

Contact information

Practice address
1702 4TH AVE E, OLYMPIA, WA 98506-4534
(360) 352-2488
Mailing address
4023 SHANA CT SE, OLYMPIA, WA 98501-5160
(360) 888-5272

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MA00010815
WA

Other

Enumeration date
10/11/2006
Last updated
07/08/2007
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