Individual
JULIO MIGUEL ILLICH CAPURRO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
4312 E F ST, TACOMA, WA 98404-1456
(253) 905-1718
Mailing address
4312 E F ST, TACOMA, WA 98404-1456
(253) 905-1718
Taxonomy
Speciality
Code
Description
License number
State
171R00000X
Interpreter
Primary
MC14545
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MC14545
INTERPRETER
WA
Enumeration date
12/14/2020
Last updated
12/14/2020
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