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Individual

MRS. KRISTINE MARIE PROCTOR

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LMP,MMP

Contact information

Practice address
13210 SE 240TH ST, SUITE A-4, KENT, WA 98042-5182
(253) 631-1118
Mailing address
17118 SE 181ST PL, RENTON, WA 98058-8759
(425) 830-8308

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MA00018749
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0182527
LABOR AND INDUSTRIES
WA
Enumeration date
01/14/2007
Last updated
07/08/2007
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