Stacey Jonelle Van Tassel, L.M.P.
NPI #1124214267 in Black Diamond, Washington
Provider Information
- NPI Number
- 1124214267
- Entity Type
- Individual
- Name
- Stacey Jonelle Van Tassel, L.M.P.
- Gender
- Not Specified
- Sole Proprietor
- Yes
- Primary Specialty
- Specialist
- Credential
- L.M.P.
- Enumeration Date
- Sep 21, 2007
- Last Updated
- Sep 21, 2007
Practice Location
- Address
- 29034 216TH AVE SE
- City
- Black Diamond
- State
- Washington
- ZIP Code
- 98010-1297
- Phone
- (360) 886-2649
Specialties & Taxonomy Codes
| Specialty |
|---|
| Specialist |
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