MATTHEW VAUGHN EDWARD PROVOST

SEATTLE, WA
NPI1073292512
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy101Y00000X Counselor
Enumeration Date2023-07-12
Last Update Date2023-07-12
Business Address
MATTHEW VAUGHN EDWARD PROVOST
1700 AIRPORT WAY S
SEATTLE, WA 98134-1618
Phone number: 206-206-4822
Mailing Address
MATTHEW VAUGHN EDWARD PROVOST
1505 6TH AVE S
SEATTLE, WA 98134-1630
Phone number: