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1124889126
KIMMETH JACK IRWIN
PASCO, WA
NPI
1124889126
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
175T00000X Peer Specialist
Enumeration Date
2024-01-17
Last Update Date
2024-01-17
Business Address
KIMMETH JACK IRWIN
1906 N 20TH AVE
PASCO, WA 99301-3393
Phone number: 509-502-1715
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Mailing Address
KIMMETH JACK IRWIN
1906 N 20TH AVE
PASCO, WA 99301-3393
Phone number: 509-502-1715
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