Individual
DERRICK MAXWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
8444 RAINIER AVE S, SEATTLE, WA 98118-4655
(253) 833-7444
Mailing address
325 W GOWE ST, KENT, WA 98032-5892
(253) 833-7444
Taxonomy
Speciality
Code
Description
License number
State
374700000X
Technician
Primary
CM60457664
WA
Other
Enumeration date
05/25/2021
Last updated
05/25/2021
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