MARIA LYNN DETHERAGE MS, RPAC
Individual Provider (NPI-1)
Active
Physician Assistant
Provider Information
- NPI Number
1720219173- Provider Type
- Individual Provider (NPI-1)
- Credentials
- MS, RPAC
- Status
- Active
Contact & Location
- Address
- 31675 PACIFIC HWY S, FEDERAL WAY, WA, 980035407
- Phone
- (253) 215-1093
- Fax
- (253) 215-1094
Specialties & Taxonomies
Physician Assistant
Primary License: WA #PA60866304