Individual
AMANDA PERGRIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMP
Contact information
Practice address
12727 SE 318TH WAY, AUBURN, WA 98092-3672
(253) 569-8215
Mailing address
12727 SE 318TH WAY, AUBURN, WA 98092-3672
(253) 569-8215
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
60523826
WA
Other
Enumeration date
03/06/2015
Last updated
03/06/2015
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