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Individual

MARILYN SELL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CO61174321

Contact information

Practice address
24823 PACIFIC HWY S, KENT, WA 98032-5478
(253) 681-0010
Mailing address
24823 PACIFIC HWY S, KENT, WA 98032-5478

Taxonomy

Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
CO61174321
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
CO61174321
SUDPT
WA
Enumeration date
08/19/2021
Last updated
08/19/2021
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