Individual
GARY MATTHEW VIRDELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
IDC
Contact information
Practice address
NAVAL HEALTH CLINIC, NAVAL STATION EVERETT, BLDG 2110, EVERETT, WA 98207
(425) 304-4076
Mailing address
3606 HUBLY RD, STANWOOD, WA 98292
(360) 652-2894
Taxonomy
Speciality
Code
Description
License number
State
1710I1002X
Independent Duty Corpsman
Primary
—
—
Other
Enumeration date
11/08/2006
Last updated
07/08/2007
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