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1407458110
KELLAN MATTHEW BURDINE
TACOMA, WA
NPI
1407458110
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
164W00000X Licensed Practical Nurse
(Licence: TX 348966)
Enumeration Date
2020-11-09
Last Update Date
2020-11-09
Business Address
KELLAN MATTHEW BURDINE
9040 JACKSON AVE, ATTN: MCHJ-CLQ-C
TACOMA, WA 98431-1100
Phone number: 520-275-3851
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Mailing Address
KELLAN MATTHEW BURDINE
9040 JACKSON AVE, ATTN: MCHJ-CLQ-C
TACOMA, WA 98431-1100
Phone number:
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