Individual
MS. KATHRYN ANN WALLACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
R.N.
Contact information
Practice address
4526 FEDERAL AVE, EVERETT, WA 98203-2132
(425) 349-6200
Mailing address
PO BOX 3810, EVERETT, WA 98213-8810
(360) 202-0529
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN00053782
WA
Other
Enumeration date
02/18/2016
Last updated
02/18/2016
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