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Individual

JOSE R ESTRELLADO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA-C

Contact information

Practice address
840 E HILL AVE, MOSES LAKE, WA 98837-2238
(509) 765-0216
Mailing address
820 N CHELAN AVE, WENATCHEE, WA 98801-2028

Taxonomy

Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA10002543
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1074335
WA
01
127395
L&I
WA
Enumeration date
07/11/2006
Last updated
06/20/2022
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