Individual
MRS. MARY MARGARET ALTENA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4014 S 270TH ST, KENT, WA 98032-7139
(253) 945-4015
Mailing address
4014 S 270TH ST, KENT, WA 98032-7139
(253) 945-4015
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
OT 00001779
WA
Other
Enumeration date
09/13/2012
Last updated
09/13/2012
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