Individual
KYLIE JEANENE SIMMONS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
TTP
Contact information
Practice address
7604 NE 5TH AVE, VANCOUVER, WA 98665-8204
(877) 378-4899
Mailing address
7604 NE 5TH AVE, VANCOUVER, WA 98665-8204
(877) 378-4899
Taxonomy
Speciality
Code
Description
License number
State
122400000X
Denturist
Primary
TP61099840
WA
Other
Enumeration date
06/08/2021
Last updated
06/08/2021
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