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Individual

PHANYA PICK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LMP

Contact information

Practice address
8002 PORTLAND AVE E, TACOMA, WA 98404-3349
(253) 223-6267
Mailing address
958 101ST STREET CT E, TACOMA, WA 98445-3143
(253) 682-9120

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
60079248
WA

Other

Enumeration date
07/28/2013
Last updated
09/14/2015
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