104TH AVENUE MEDICAL CLINIC INCORPORATED
Organization (NPI-2)
Active
Clinic/Center
Provider Information
- NPI Number
1396921326- Provider Type
- Organization / Facility (NPI-2)
- Status
- Active
Contact & Location
- Address
- 24604 104TH AVE SE # 202, KENT, WA, 980305385
- Phone
- (253) 859-8371
- Fax
- (253) 859-9593
Specialties & Taxonomies
Clinic/Center
Primary License: WA #37861