institution
Waterfalls Longevity Center Pllc
Obstetrics Physician in Yelm, Washington
NPI 1154863157

Waterfalls Longevity Center Pllc is a Obstetrics Physician based in Yelm, WA and is specialized in Obstetrics. Waterfalls Longevity Center Pllc practices in Yelm, WA. The NPI Number for Waterfalls Longevity Center Pllc is 1154863157 and holds a License No. 00046050 (Washington).

The current practice location address for Waterfalls Longevity Center Pllc is 9144 Burnett Rd Se, Yelm, WA and can be reached out via phone at 360-400-2111 and via fax at 360-400-2112.

Location: 9144 Burnett Rd Se, Yelm, WA, 98597-8488
institution
Provider Profile Details
NPI Number
1154863157
Provider Name
Waterfalls Longevity Center Pllc
Credential
Provider Entity Type
Organization
Address
9144 Burnett Rd Se, Yelm, WA, 98597-8488
Phone Number
360-400-2111
Fax Number
360-400-2112
Provider Enumeration Date
11/08/2016
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
MD00046050 01 WA PHYSICIAN LICENSE
institution
Provider Business Practice Location Address Details
Address
9144 Burnett Rd Se
City
State
Zip
98597-8488
Phone Number
360-400-2111
Fax Number
360-400-2112
person
Provider Business Mailing Address Details
Address
9144 Burnett Rd Se
City
State
Zip
98597-8488
Phone Number
360-400-2111
Fax Number
360-400-2112
person
Provider's Taxonomy Details 1
Type
Allopathic & Osteopathic Physicians
Classification
Obstetrics & Gynecology
Speciality
Obstetrics
Taxonomy
License No.
00046050 (Washington)
Definition
Definition to come...
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