Individual
GWENDOLYN JEAN MCMURTREY INGELS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
17011 S VAUGHN ROAD KPN, VAUGHN, WA 98394
(253) 303-0239
Mailing address
PO BOX 143, VAUGHN, WA 98394-0143
(253) 303-0239
Taxonomy
Speciality
Code
Description
License number
State
372600000X
Adult Companion
—
—
3747A0650X
Attendant Care Provider
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
051868792
—
WA
05
—
200387647
—
WA
Enumeration date
07/29/2011
Last updated
07/29/2011
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