Individual
ATHENA ORTEGA-OWEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMP
Contact information
Practice address
1036 SHADBERRY CT SE, OLYMPIA, WA 98513-6672
(360) 456-4274
Mailing address
1036 SHADBERRY CT SE, OLYMPIA, WA 98513-6672
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MA00022767
WA
Other
Enumeration date
11/01/2011
Last updated
11/01/2011
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