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1356050744
SYDNEY FOUNTAIN
CENTRALIA, WA
NPI
1356050744
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363A00000X Physician Assistant
(Licence: WA PA61514013)
Enumeration Date
2022-11-15
Last Update Date
2024-04-03
Business Address
SYDNEY FOUNTAIN PA-C
1000 S SCHEUBER RD
CENTRALIA, WA 98531-8877
Phone number: 360-330-8950
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Mailing Address
SYDNEY FOUNTAIN PA-C
PO BOX 3360
PORTLAND, OR 97208-3360
Phone number:
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