Individual
THERESA CLARY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMP
Contact information
Practice address
205 E JAMES ST, SUITE # 100, KENT, WA 98032-4555
(206) 579-5007
(253) 631-2090
Mailing address
18125 SE 246TH ST, COVINGTON, WA 98042-4851
(206) 579-5007
(253) 631-2090
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
MA00018777
WA
Other
Enumeration date
03/01/2007
Last updated
07/08/2007
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