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1912096306
KEVIN R LONG
TACOMA, WA
NPI
1912096306
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
174400000X Specialist
(Licence: WA MA00016150)
Enumeration Date
2006-10-12
Last Update Date
2008-05-15
Business Address
Mr. KEVIN R LONG L.M.P.
4902 TACOMA MALL BLVD
TACOMA, WA 98409-7149
Phone number: 253-473-0300
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Mailing Address
Mr. KEVIN R LONG L.M.P.
3217 EASTLAKE AVE E APT 304
SEATTLE, WA 98102-7124
Phone number: 253-224-0103
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