Individual
MRS. KELLY BONAVENA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
L.AC, MSOM
Contact information
Practice address
102 N MERIDIAN, UNIT 3A, PUYALLUP, WA 98371-8630
(253) 970-8256
(206) 420-7133
Mailing address
12221 SHOREWOOD DR SW, BURIEN, WA 98146-2411
(203) 824-2625
(206) 420-7133
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
AC 00003070
WA
Other
Enumeration date
07/23/2008
Last updated
07/28/2008
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