Healthcare Provider Details

I. General information

NPI: 1487885703
Provider Name (Legal Business Name): PAULA J SOMMERVILLE D.V.M.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/04/2009
Last Update Date: 08/04/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5710 RUDDELL RD SE STE 2
LACEY WA
98503-6424
US

IV. Provider business mailing address

5710 RUDDELL RD SE STE 2
LACEY WA
98503-6424
US

V. Phone/Fax

Practice location:
  • Phone: 360-455-8090
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174M00000X
TaxonomyVeterinarian
License NumberVT00004827
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: