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Individual

KARISSA KAYLEEN COUNCILL-TRINIDAD

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MA00021954

Contact information

Practice address
3223 TULALIP AVE, EVERETT, WA 98201-4155
(425) 293-2639
Mailing address
3223 TULALIP AVE, EVERETT, WA 98201-4155
(425) 293-2639

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MA00021954
WA

Other

Enumeration date
05/29/2015
Last updated
05/29/2015
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