Individual
TERRA MCKEOWN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMP
Contact information
Practice address
108 19TH AVE, SEATTLE, WA 98122-5732
(425) 263-6048
Mailing address
108 19TH AVE, SEATTLE, WA 98122-5732
(425) 263-6048
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MA60267546
WA
Other
Enumeration date
07/24/2014
Last updated
07/24/2014
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