Individual
TABITA G IBARRA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1916 N 30TH ST, MOUNT VERNON, WA 98273-8914
(360) 550-0669
Mailing address
1916 N 30TH ST, MOUNT VERNON, WA 98273-8914
(360) 550-0669
Taxonomy
Speciality
Code
Description
License number
State
171R00000X
Interpreter
Primary
MC12986
WA
Other
Enumeration date
09/07/2020
Last updated
09/07/2020
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