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1912629601
LACEY BRANTNER
PUYALLUP, WA
NPI
1912629601
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363LP0200X Nurse Practitioner, Pediatrics
(Licence: WA AP61358655)
Enumeration Date
2022-09-19
Last Update Date
2022-09-19
Business Address
LACEY BRANTNER ARNP
11102 SUNRISE BLVD E STE 104
PUYALLUP, WA 98374-8846
Phone number: 253-848-8797
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Mailing Address
LACEY BRANTNER ARNP
17125 140TH AVE E
PUYALLUP, WA 98374-9151
Phone number: 253-579-4532
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