Individual
DR. BRENT PACKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4220 INGLESIDE DR SE, LACEY, WA 98503-2108
(360) 456-3429
Mailing address
4220 INGLESIDE DR SE, LACEY, WA 98503-2108
(360) 456-3429
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
MD00033748
WA
Other
Enumeration date
01/19/2007
Last updated
07/08/2007
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