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Individual

MS. JOANNE MARIE FOWLER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LMP

Contact information

Practice address
26405 103RD AVE SE, KENT, WA 98030-7026
(253) 921-5875
Mailing address
26405 103RD AVE SE, KENT, WA 98030-7026
(253) 921-5875

Taxonomy

Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
WA00009587
WA

Other

Enumeration date
04/02/2007
Last updated
07/08/2007
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