Matt Childs Valid NPI
Individual provider · Supports Brokerage Agency · North Bend, WA
- NPI
- 1134717747
- Type
- Individual (Type 1)
- Primary specialty
- Supports Brokerage Agency (Supports Brokerage)
- Specialty group
- Agencies
- Taxonomy code
- 251X00000X
- License number
- 1031895 (WA)
- Sex
- Male
- Sole proprietor
- Yes
- Enumerated
- 2021-01-08
- Last updated
- 2021-01-08
Practice location
1315 11th Ct Sw
North Bend, WA 98045-7989
(812) 251-6639