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1487157020
PRIM PREY KY
LACEY, WA
NPI
1487157020
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Former Name
PRIM PREY LY
Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
363A00000X Physician Assistant
(Licence: WA PA60763223)
Enumeration Date
2018-03-09
Last Update Date
2024-08-26
Business Address
PRIM PREY KY PA-C
1350 MARVIN RD NE STE D
LACEY, WA 98516-3877
Phone number: 888-227-3312
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Mailing Address
PRIM PREY KY PA-C
PO BOX 2928
PORTLAND, OR 97208-2928
Phone number: 425-207-5155
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