Individual
KYLE JOSEPH MICON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
607 SE EVERETT MALL WAY, EVERETT, WA 98208-3248
(425) 265-7000
Mailing address
14515 N CREEK DR APT A307, MILL CREEK, WA 98012-5767
(716) 799-3541
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
AP60763393
WA
Other
Enumeration date
08/15/2017
Last updated
08/15/2017
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