Individual
MAWATTA BAMBA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
24620 RUSSELL RD APT 106, KENT, WA 98032-4727
(206) 468-8105
Mailing address
24620 RUSSELL RD APT 106, KENT, WA 98032-4727
(206) 468-8105
Taxonomy
Speciality
Code
Description
License number
State
3747A0650X
Attendant Care Provider
Primary
—
—
Other
Enumeration date
04/27/2022
Last updated
04/27/2022
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