Individual
MR. KYLE EUGENE CLYDE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LMP
Contact information
Practice address
2809 MERIDIAN E., EDGEWOOD, WA 98371
(253) 840-1100
(253) 840-1199
Mailing address
2809 MERIDIAN E., EDGEWOOD, WA 98371
(253) 840-1100
(253) 840-1199
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MA00015312
WA
Other
Enumeration date
04/17/2007
Last updated
07/08/2007
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