Individual
ANTONIO JOSE CARRASCO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD, PHD
Contact information
Practice address
100 E 33RD ST, SUITE 100, VANCOUVER, WA 98663
(360) 514-7550
(360) 514-7553
Mailing address
1115 SE 164TH AVE, DEPT 358, VANCOUVER, WA 98683-9324
(360) 514-7550
(360) 514-7553
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
ML60066899
WA
Other
Enumeration date
06/26/2009
Last updated
08/02/2018
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