Individual
DESTINY ROSE FULLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
11410 NE 122ND WAY STE 100, KIRKLAND, WA 98034-6927
(425) 650-4005
Mailing address
11410 NE 122ND WAY STE 100, KIRKLAND, WA 98034-6927
(425) 650-4005
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
WA
Other
Enumeration date
04/10/2026
Last updated
04/10/2026
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