Individual
MS. TRENA RAE WARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
135 W MAIN ST, CHEHALIS, WA 98532-4817
(360) 748-6696
Mailing address
814 SW 19TH ST, CHEHALIS, WA 98532-4010
(360) 748-4317
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
RC00053177
WA
Other
Enumeration date
01/05/2007
Last updated
07/08/2007
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