Individual
PRESTON ERIC LOPEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
9040A JACKSON AVE, JOINT BASE LEWIS MCCHORD, WA 98431-5001
(253) 968-1790
Mailing address
9040A JACKSON AVE, JOINT BASE LEWIS MCCHORD, WA 98431-0001
(253) 968-1790
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
—
—
363AS0400X
Surgical Physician Assistant
Primary
—
—
Other
Enumeration date
07/11/2012
Last updated
08/24/2023
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