Individual
VANESSA JULIE IGLESIAS MEHTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
5128 YELM HWY SE, SUITE E, LACEY, WA 98503
(708) 652-2040
Mailing address
5128 YELM HWY SE, SUITE E, LACEY, WA 98503
(708) 652-2040
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
085.005976
IL
Other
Enumeration date
10/14/2016
Last updated
11/08/2019
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