Individual
MRS. ANISSA CORDOVA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMP
Contact information
Practice address
1107 OHIO AVE, BREMERTON, WA 98337-1334
(360) 627-7396
Mailing address
1107 OHIO AVE, BREMERTON, WA 98337-1334
(360) 627-7396
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MA 60089202
WA
Other
Enumeration date
09/22/2010
Last updated
09/22/2010
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