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Individual

DR. KENNETH ROSS MACMAHON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
O.D.

Contact information

Practice address
365 RENTON CENTER WAY SW, SUITE D, RENTON, WA 98055-2324
(425) 255-4630
(425) 255-4688
Mailing address
4123 178TH LN SE APT 3, BELLEVUE, WA 98008-5986

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
3754
WA

Other

Enumeration date
04/09/2007
Last updated
07/08/2007
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