Individual
PAUL WATTERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
315 MARTIN LUTHER KING JR WAY, TACOMA, WA 98405-4234
(253) 406-1000
(253) 864-2779
Mailing address
PO BOX 5299, MS: 820-5-PCO, TACOMA, WA 98415-0299
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA61462197
WA
390200000X
Student in an Organized Health Care Education/Training Program
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Other
Enumeration date
01/05/2023
Last updated
03/20/2024
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