Organization
PRUDENCIO G TIBLE MD PC
Active
Other names
Ranier Beach Medical Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
MR. PRUDENCIO GALVEZ TIBLE MD (PRESIDENT)
(206) 725-8043
Entity
Organization
Contact information
Practice address
5023 S BARTON PLACE, SEATTLE, WA 98118
(206) 725-8043
(206) 760-1359
Mailing address
PO BOX 18936, SEATTLE, WA 98118
(206) 725-8043
(206) 760-1359
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Enumeration date
09/15/2006
Last updated
08/22/2020
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