Individual
MR. FERNANDO MEDINA-DELVALLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA C
Contact information
Practice address
888 SWIFT BLVD, RICHLAND, WA 99352-3514
(509) 946-4611
(509) 942-2757
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
Primary
PA10003301
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0202692
LIWA
WA
01
—
8349086
BSWA
WA
05
—
8349086
—
WA
Enumeration date
07/13/2006
Last updated
03/04/2008
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