Individual
TANNER MICHAEL KENNEDY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
17807 CROOKED MILE RD APT 7, GRANITE FALLS, WA 98252-8742
(425) 598-3600
Mailing address
1242 STATE AVE. STE. I PMB 93, MARYSVILLE, WA 98270
(425) 598-3600
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
HM60927797
WA
Other
Enumeration date
03/28/2019
Last updated
03/28/2019
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