Individual
CHRISTOPHER MICHAEL LAISE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2430 N 13TH ST, SHELTON, WA 98584-1213
(360) 426-1651
Mailing address
2019 14TH AVE NW APT F254, GIG HARBOR, WA 98335-1665
(253) 302-1196
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
60790708
WA
Other
Enumeration date
10/03/2017
Last updated
10/03/2017
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