Organization
MARANATHA MEDICAL CLINIC INC P S
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DANIEL L GRAVES MD (PRESIDENT)
(425) 235-9614
Entity
Organization
Contact information
Practice address
17900 TALBOT RD S, #101, RENTON, WA 98055-8212
(425) 235-9614
(425) 235-1060
Mailing address
17900 TALBOT ROAD SOUTH, #101, RENTON, WA 98055-8636
(425) 235-9614
(425) 235-1060
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
17917
WA
Other
Enumeration date
10/29/2009
Last updated
09/11/2017
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