Individual
KENNETH JAY ROBLES SELERIO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
9040 JACKSON AVE MADIGAN ARMY MEDICAL CENTER, JOINT BASE LEWIS MCCHORD, WA 98431-2414
(253) 968-2252
(253) 968-3278
Mailing address
9040 JACKSON AVE MADIGAN ARMY MEDICAL CENTER, JOINT BASE LEWIS MCCHORD, WA 98431-0001
(253) 968-2252
(253) 968-3278
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
088127
TN
Other
Enumeration date
01/12/2012
Last updated
02/20/2019
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