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1619742905
GAVIN WAYNE LONG
SEATTLE, WA
NPI
1619742905
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date
2023-11-16
Last Update Date
2023-11-16
Business Address
GAVIN WAYNE LONG
1959 NE PACIFIC ST
SEATTLE, WA 98195-0001
Phone number: 206-543-0903
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Mailing Address
GAVIN WAYNE LONG
1959 NE PACIFIC ST
SEATTLE, WA 98195-6365
Phone number: 206-543-0903
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