Individual
MARTINEZ KILGORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1305 TACOMA AVE S STE 305, TACOMA, WA 98402-1903
(360) 559-7972
Mailing address
1106 K ST, CENTRALIA, WA 98531-3242
(360) 559-7972
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
—
WA
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
11/29/2023
Last updated
11/29/2023
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