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Individual

RAFAEL A GONZALEZ-VIZOSO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
3455 S 344TH WAY, SUITE 210, FEDERAL WAY, WA 98001-9560
(180) 033-6861
(253) 838-6418
Mailing address
505 S 336TH ST, SUITE 600, FEDERAL WAY, WA 98003-6328
(180) 033-6861
(253) 838-6418

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
MD00033490
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0213580
LIWA
WA
01
5971GO
BSWA
WA
05
8187320
WA
01
P00370054
RRGA
WA
Enumeration date
10/18/2006
Last updated
03/13/2020
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