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1720219173
MARIA LYNN DETHERAGE
FEDERAL WAY, WA
NPI
1720219173
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363A00000X Physician Assistant
(Licence: WA PA60866304)
Enumeration Date
2009-08-03
Last Update Date
2020-11-12
Business Address
MARIA LYNN DETHERAGE MS, RPAC
31675 PACIFIC HWY S
FEDERAL WAY, WA 98003-5407
Phone number: 253-215-1093
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Mailing Address
MARIA LYNN DETHERAGE MS, RPAC
31675 PACIFIC HWY S
FEDERAL WAY, WA 98003-5407
Phone number: 253-215-1093
Copy
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