Individual
MARY JO BUKOVIC
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CCP
Contact information
Practice address
1100 9TH AVE, SEATTLE, WA 98101-2756
(206) 223-6600
Mailing address
4043 S ABILENE CIR, #A, AURORA, CO 80014-7377
(303) 627-4008
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
—
WA
Other
Enumeration date
11/28/2012
Last updated
11/28/2012
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