Kylie Raeann Black, PA-C

NPI #1780302828 in Monroe, Washington

Provider Information

NPI Number: 1780302828
Entity Type: Individual
Name: Kylie Raeann Black, PA-C
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physician Assistant
Credential: PA-C
Enumeration Date: Aug 15, 2022
Last Updated: Sep 4, 2024

Practice Location

Address: 17707 W MAIN ST FL 1
City: Monroe
State: Washington
ZIP Code: 98272-1967
Phone: (360) 282-3885

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physician Assistant	363A00000X	Primary

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