Individual
KC GRAHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
237 PROFESSIONAL WAY, SHELTON, WA 98584-4404
(360) 426-2500
Mailing address
237 PROFESSIONAL WAY, SHELTON, WA 98584-4404
(360) 426-2500
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA60509798
WA
Other
Enumeration date
10/30/2014
Last updated
10/30/2014
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