Individual
DOMINIQUE LIDDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
925 SENECA ST, MAIL STOP: H8-GME, SEATTLE, WA 98101
(206) 583-6079
Mailing address
2000 SW 16TH ST APT 27, GAINESVILLE, FL 32608-1437
(305) 318-1964
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
03/29/2024
Last updated
03/29/2024
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