Individual
MS. KAREENA ANGELA FOUNTAIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMP
Contact information
Practice address
17719 JORDAN ST SW, ROCHESTER, WA 98579-8533
(360) 359-2736
(360) 273-5809
Mailing address
17719 JORDAN ST SW, ROCHESTER, WA 98579-8533
(360) 359-2736
(360) 273-5809
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
601686008
WA
Other
Enumeration date
02/18/2011
Last updated
02/18/2011
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