Individual
COLLEEN KOST
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMP
Contact information
Practice address
1307 MERKEL ST NE, LACEY, WA 98516-5423
(360) 250-6869
Mailing address
1307 MERKEL ST NE, LACEY, WA 98516-5423
(360) 250-6869
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MA60259055
WA
Other
Enumeration date
03/08/2012
Last updated
06/07/2013
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