Organization
MAZIMO AZUCENA AFH
Active
Organization
MAZIMO AZUCENA AFH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MAXIMO DIMAUNAHAN AZUCENA (PROVIDER)
(425) 322-5328
Entity
Organization
Contact information
Practice address
10522 19TH PL W, EVERETT, WA 98204-3663
(425) 322-5328
(425) 322-5328
Mailing address
10522 19TH PL W, EVERETT, WA 98204-3663
(425) 322-5328
(425) 322-5328
Taxonomy
Speciality
Code
Description
License number
State
302F00000X
Exclusive Provider Organization
Primary
751038
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1115019
—
WA
Enumeration date
10/16/2014
Last updated
10/16/2014
Update your record
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