Individual
GREGORY TODD SKIDMORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMP
Contact information
Practice address
5508 31ST AVE S, SEATTLE, WA 98108-3078
(206) 953-2443
Mailing address
5508 31ST AVE S, SEATTLE, WA 98108-3078
(206) 953-2443
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MA60204102
WA
Other
Enumeration date
02/18/2011
Last updated
02/18/2011
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