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Laci Malaya King

NPI Registration Record

Provider / OrganizationNPIDate Certified
LACI MALAYA KING16296705912020-11-14
Entity TypeIndividual
Provider Name Laci Malaya King
Practice Office Address1033 SW 152ND ST
BURIEN, WA US
Practice Office Telephone2062421698
Mailing Address427 173RD ST S
SPANAWAY, WA 983878714 US
Business Telephone2532931178
HPT Codes
CodeLicense NoState
101Y00000X PRIMARY
OPI Codes

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