Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 124Q00000X | Dental Hygienist | DH60402339 | WA |
NPI | 1083041719 |
---|---|
Provider Name | Lonnie Druffel |
First Address | Spokane, WA 99201-0254 |
Second Address | Clarkston, WA 99403-2013 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 26/09/2013 |
Last Update Date | 26/09/2013 |