Individual
MR. GREGORY SCOTT WATSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
2121 S 19TH ST, TACOMA, WA 98405-2922
(253) 301-6850
Mailing address
2121 S 19TH ST, TACOMA, WA 98405-2922
(253) 301-6850
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
.60236031
WA
363AM0700X
Medical Physician Assistant
001656
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001656
LICENSE
IA
01
—
60236031
LICENSE
WA
Enumeration date
07/18/2006
Last updated
09/25/2012
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