Individual
SAMUEL BALLESTEROS ECHAURE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
9040 JACKSON AVE JOINT BASE LEWIS MCCHORD, TACOMA, WA 98431-8273
(253) 968-5480
Mailing address
3447 JUNO ST NE, LACEY, WA 98516-4503
(951) 237-9204
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
A44205
CA
Other
Enumeration date
09/20/2006
Last updated
02/20/2019
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