Individual
MR. JOSE MANUEL HERNANDEZ II
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
950 BROADWAY STE 301, TACOMA, WA 98402-4454
(253) 671-9909
Mailing address
4706 CALDWELL RD E, EDGEWOOD, WA 98372-9221
(360) 927-6758
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
CB61550345
WA
Other
Enumeration date
05/01/2024
Last updated
05/01/2024
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