Provider Demographics
NPI:1245561190
Name:FOSTER, CYNTHIA CAROL (MA 60066174)
Entity Type:Individual
Prefix:MRS
First Name:CYNTHIA
Middle Name:CAROL
Last Name:FOSTER
Suffix:
Gender:F
Credentials:MA 60066174
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:204PINEHURSTDR.SW.
Mailing Address - Street 2:
Mailing Address - City:TUMWATER
Mailing Address - State:WA
Mailing Address - Zip Code:98501
Mailing Address - Country:US
Mailing Address - Phone:360-352-8112
Mailing Address - Fax:360-352-8113
Practice Address - Street 1:204PINEHURST DR.SW.
Practice Address - Street 2:
Practice Address - City:TUMWATER
Practice Address - State:WA
Practice Address - Zip Code:98501-4500
Practice Address - Country:US
Practice Address - Phone:360-352-8112
Practice Address - Fax:360-352-8113
Is Sole Proprietor?:No
Enumeration Date:2010-01-15
Last Update Date:2010-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist