Individual
MS. CARMEN MARIE DIAZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RDA
Contact information
Practice address
7241 S MONROE ST, TACOMA, WA 98409-2445
(253) 678-2564
Mailing address
7241 S MONROE ST, TACOMA, WA 98409-2445
(253) 678-2564
Taxonomy
Speciality
Code
Description
License number
State
126800000X
Dental Assistant
D160049121
WA
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
01/15/2010
Last updated
01/15/2010
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