Individual
MR. ANTONIO DANTE MARINO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
707 W 13TH ST, VANCOUVER, WA 98660-2809
(360) 397-2211
Mailing address
3914 G ST, VANCOUVER, WA 98663-1838
(360) 907-9461
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA.PA.60980056
WA
Other
Enumeration date
10/14/2019
Last updated
10/15/2019
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