Individual
MRS. DEANNA LILA FULLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
21417 122ND PLACE SE, KENT, WA 98031
(253) 639-0094
(253) 639-0094
Mailing address
21417 122ND PLACE SE, KENT, WA 98031
(253) 639-0094
(253) 639-0094
Taxonomy
Speciality
Code
Description
License number
State
3747A0650X
Attendant Care Provider
Primary
—
WA
Other
Enumeration date
09/26/2019
Last updated
09/26/2019
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