Individual
DEBRA R KENNEDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN, LMP
Contact information
Practice address
9416 271ST ST NW, STANWOOD, WA 98292-8094
(360) 629-0110
Mailing address
PO BOX 1318, STANWOOD, WA 98292-1318
(360) 629-0110
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN00095745
WA
225700000X
Massage Therapist
Primary
MA 60172187
WA
Other
Enumeration date
11/15/2010
Last updated
11/17/2011
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