Individual
EARL JAMES KETCHUM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMP
Contact information
Practice address
15236 NE 191ST PL, WOODINVILLE, WA 98072-8442
(206) 819-6859
Mailing address
15236 NE 191ST PL, WOODINVILLE, WA 98072-8442
(206) 819-6859
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MA00009821
WA
Other
Enumeration date
01/14/2009
Last updated
01/14/2009
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