Individual
MONTANA MAICHEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMP, CIMI
Contact information
Practice address
6013 LAKE SAINT CLAIR DR SE, OLYMPIA, WA 98513-9219
(360) 402-1788
Mailing address
6013 LAKE SAINT CLAIR DR SE, OLYMPIA, WA 98513-9219
(360) 402-1788
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MA 60091741
WA
Other
Enumeration date
09/16/2009
Last updated
09/16/2009
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