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1225655251
ERIC DALE MAGNUSON
SEATTLE, WA
NPI
1225655251
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
390200000X Student in an Organized Health Care Education/Training Program
(Licence: WA CO60899549)
Enumeration Date
2020-06-25
Last Update Date
2020-06-25
Business Address
ERIC DALE MAGNUSON SIDPT
1305 SENECA ST
SEATTLE, WA 98101-2828
Phone number: 206-323-0934
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Mailing Address
ERIC DALE MAGNUSON SIDPT
4415 HOYT AVE APT 1
EVERETT, WA 98203-2348
Phone number: 425-268-6212
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