Ketarae Ann Konshuk, LMP
NPI #1992912331 in Mount Vernon, Washington
Provider Information
- NPI Number
- 1992912331
- Entity Type
- Individual
- Name
- Ketarae Ann Konshuk, LMP
- Gender
- Not Specified
- Sole Proprietor
- Yes
- Primary Specialty
- Specialist
- Credential
- LMP
- Enumeration Date
- May 16, 2007
- Last Updated
- Jul 8, 2007
Practice Location
- Address
- 619 W HAZEL ST
- City
- Mount Vernon
- State
- Washington
- ZIP Code
- 98273-4827
- Phone
- (360) 610-1693
Specialties & Taxonomy Codes
| Specialty |
|---|
| Specialist |
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