Individual
FARA LYNN GROSSMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMP
Contact information
Practice address
726 BROADWAY, SUITE 101, SEATTLE, WA 98122-4378
(206) 962-0217
Mailing address
726 BROADWAY, SUITE 101, SEATTLE, WA 98122-4378
(206) 962-0217
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MA00016695
WA
Other
Enumeration date
05/17/2007
Last updated
07/08/2007
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