Individual
HECTOR MANUEL GUTIERREZ JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA C
Contact information
Practice address
520 N 4TH AVE, PASCO, WA 99301-5257
(509) 547-7704
(509) 542-3032
Mailing address
505 S 336TH ST, SUITE 600, FEDERAL WAY, WA 98003-6328
(253) 838-6180
(253) 838-6418
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
PA10003370
WA
363A00000X
Physician Assistant
Primary
PA10003370
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0202688
LIWA
WA
01
—
0222295
LIWA
WA
01
—
3075GU
BSWA
WA
01
—
3945GU
BSWA
WA
05
—
8323081
—
WA
Enumeration date
06/22/2006
Last updated
04/16/2013
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