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1356905038
MICK PHRAKONEKHAM
SEATTLE, WA
NPI
1356905038
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
224Z00000X Occupational Therapy Assistant
Enumeration Date
2019-04-27
Last Update Date
2019-04-27
Business Address
MICK PHRAKONEKHAM OC60942789
2717 DEXTER AVE N
SEATTLE, WA 98109-1914
Phone number: 206-284-7012
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Mailing Address
MICK PHRAKONEKHAM OC60942789
25117 SW PARKWAY AVE
WILSONVILLE, OR 97070-9697
Phone number:
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