Individual
MISS JOSILU PORTELLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHYSICIANS ASSISTANT
Contact information
Practice address
3620 JOSEPH SIEWICK DR, SUITE 406, FAIRFAX, VA 22033-1756
(703) 359-8640
(703) 591-6105
Mailing address
3620 JOSEPH SIEWICK DR, SUITE 406, FAIRFAX, VA 22033-1756
(703) 359-8640
(703) 591-6105
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
—
VA
Other
Enumeration date
08/04/2006
Last updated
10/19/2010
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