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1093002172
KANYAKANIT BUPPAWONG DEPAZ
BELLEVUE, WA
NPI
1093002172
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
172M00000X Mechanotherapist
(Licence: WA MA 00024931)
Enumeration Date
2011-07-08
Last Update Date
2011-07-08
Business Address
Mrs. KANYAKANIT BUPPAWONG DEPAZ LMP
14850 LAKE HILLS BLVD # 4
BELLEVUE, WA 98007-5800
Phone number: 425-558-9441
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Mailing Address
Mrs. KANYAKANIT BUPPAWONG DEPAZ LMP
308 146TH PL NE
BELLEVUE, WA 98007-4941
Phone number: 206-235-5557
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