Individual
LACEY BRANTNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
11102 SUNRISE BLVD E STE 104, PUYALLUP, WA 98374-8846
(253) 848-8797
Mailing address
17125 140TH AVE E, PUYALLUP, WA 98374-9151
(253) 579-4532
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
AP61358655
WA
Other
Enumeration date
09/19/2022
Last updated
09/19/2022
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