Individual
DR. ANDRE BARRANDA BAUTISTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1304 FAWCETT AVE STE 100, TACOMA, WA 98402-1900
(253) 761-4200
Mailing address
1304 FAWCETT AVE STE 100, TACOMA, WA 98402-1900
(253) 761-4200
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
MD60545139
WA
2085R0204X
Vascular & Interventional Radiology Physician
Primary
MD60545139
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2044117
—
WA
Enumeration date
04/15/2009
Last updated
10/04/2024
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