Individual
MARTHA MORENO FLOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
305 PACIFIC AVE S, KELSO, WA 98626-1638
(360) 425-5378
Mailing address
604 N 12TH AVE, KELSO, WA 98626-4759
(360) 578-1672
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
00050860
WA
Other
Enumeration date
12/06/2022
Last updated
12/06/2022
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