Individual
MIA LYNN PAKOOTAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA-P,MA-R
Contact information
Practice address
39 SHORTCUT RD, INCHELIUM, WA 99138
(509) 722-7006
Mailing address
PO BOX 290, INCHELIUM, WA 99138-0290
(509) 722-7006
Taxonomy
Speciality
Code
Description
License number
State
246RM2200X
Medical Laboratory Technician
Primary
PC61401184
WA
Other
Enumeration date
09/11/2023
Last updated
09/11/2023
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