104100000X
Tacoma, WA
Specialty
104100000X
Credential
LISW
NPI
1497903959
209 Martin Luther King Jr Way, Tacoma, WA 98405
(253) 403-3378Confirm current license and practice information on the official CMS NPI registry.
View NPI RecordThis surgeon specializes in 104100000x procedures performed in an outpatient ambulatory surgical setting.
NUCC Taxonomy: 104100000X