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1164044731
KASEY NICOLE FONTAINE
SEATTLE, WA
NPI
1164044731
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
363A00000X Physician Assistant
(Licence: WA PA61270555)
Enumeration Date
2020-05-17
Last Update Date
2022-07-25
Business Address
KASEY NICOLE FONTAINE PA-C
5350 TALLMAN AVE NW STE 420
SEATTLE, WA 98107-3932
Phone number: 206-781-6161
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Mailing Address
KASEY NICOLE FONTAINE PA-C
PO BOX 25608
SALT LAKE CITY, UT 84125-0608
Phone number: 206-320-4476
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