Individual
KELLY JEAN PALMER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
12711 SE MILL PLAIN BLVD, VANCOUVER, WA 98684-6053
(360) 896-4484
Mailing address
2610 NE 100TH ST, VANCOUVER, WA 98686-5799
(360) 896-4484
Taxonomy
Speciality
Code
Description
License number
State
126800000X
Dental Assistant
Primary
D160030138
WA
Other
Enumeration date
01/22/2014
Last updated
01/22/2014
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