Individual
MANUEL ENRIQUE SIERRA ASCENCIO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
4420 76TH ST NE, MARYSVILLE, WA 98270-3726
(360) 651-7491
Mailing address
PO BOX 5127, EVERETT, WA 98206-5127
(360) 651-7491
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
51796
MN
207R00000X
Internal Medicine Physician
Primary
MD60663211
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2068151
—
WA
Enumeration date
01/21/2009
Last updated
03/15/2017
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