Individual
THI TUYET MAI TA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
4516 S 220TH PL UNIT 63, KENT, WA 98032-1812
(206) 742-8051
Mailing address
4516 S 220TH PL UNIT 63, KENT, WA 98032-1812
(206) 742-8051
Taxonomy
Speciality
Code
Description
License number
State
133N00000X
Nutritionist
Primary
NU61253261
WA
Other
Enumeration date
04/25/2023
Last updated
04/25/2023
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