Individual
PANISIMA KANOKKAEW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1220 116TH AVE NE #203, BELLEVUE, WA 98004
(425) 208-9836
Mailing address
580 FRONT ST S APT. D212, ISSAQUAH, WA 98027
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MA00022414
WA
Other
Enumeration date
06/30/2009
Last updated
06/30/2009
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