Individual
MRS. KALEIGH MARIE FENTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
MADIGAN ARMY MEDICAL CENTER 9040 JACKSON AVE, ATTN: MCHJ-CLQ-C, TACOMA, WA 98431-1100
(253) 968-5090
Mailing address
2602 WESTRIDGE AVE W APT S304, TACOMA, WA 98466-8271
(636) 524-5445
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
146076
MO
Other
Enumeration date
10/22/2016
Last updated
10/22/2016
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