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Individual

DR. JOHN K MAYENO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
17900 TALBOT RD, S # 102, RENTON, WA 98055
(425) 255-9310
(425) 255-6229
Mailing address
17900 TALBOT RD, S # 102, RENTON, WA 98055
(425) 255-9310
(425) 255-6229

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD00023599
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1026137
WA
Enumeration date
08/23/2006
Last updated
07/08/2007
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