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Individual

BONNIE KEEN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
927 E FAIRHAVEN AVE, BURLINGTON, WA 98233-1918
(360) 757-3311
Mailing address
927 E FAIRHAVEN AVE, BURLINGTON, WA 98233-1918
(360) 757-3311

Taxonomy

Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
P1 60469533
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1016728
WA
Enumeration date
05/01/2015
Last updated
05/01/2015
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