Individual
KABAL SRIVIBOON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
20818 44TH AVE W SUITE 270, LYNNWOOD, WA 98036
(425) 712-0802
(425) 712-0641
Mailing address
20818 44TH AVE W STE 270, LYNNWOOD, WA 98036-7709
(425) 712-0802
(425) 712-0641
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
CB60816035
WA
Other
Enumeration date
06/27/2018
Last updated
06/27/2018
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