Individual
GWEN MARIE DEMAREST
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
26630 40TH AVE S, KENT, WA 98032-7017
(253) 945-5100
Mailing address
2008 N CEDAR ST, TACOMA, WA 98406-6636
(253) 495-1915
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LP60452384
WA
Other
Enumeration date
11/21/2017
Last updated
11/21/2017
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