FONABEI AYONGABA
Individual Provider (NPI-1)
Active
Nurse Practitioner, Psych/Mental Health
Provider Information
- NPI Number
1104532944- Provider Type
- Individual Provider (NPI-1)
- Status
- Active
Contact & Location
- Address
- 605 WOODLAND SQUARE LOOP SE, LACEY, WA, 985031045
- Phone
- (844) 949-8888
Specialties & Taxonomies
Registered Nurse
License: WA #RN61094794
Nurse Practitioner, Psych/Mental Health
Primary License: WA #AP61475276