Individual
FANTA DUKULY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
802 45TH ST NE APT 12-102, AUBURN, WA 98002-1405
(206) 823-4585
Mailing address
802 45TH ST NE APT 12-102, AUBURN, WA 98002-1405
(206) 823-4585
Taxonomy
Speciality
Code
Description
License number
State
3747A0650X
Attendant Care Provider
Primary
—
—
Other
Enumeration date
10/19/2021
Last updated
10/19/2021
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