Individual
JESUS VICENTE CASINO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
6401 KIMBALL DR, GIG HARBOR, WA 98335-1228
(253) 858-9192
(253) 858-4348
Mailing address
6401 KIMBALL DR, GIG HARBOR, WA 98335-1228
(253) 858-9192
(253) 858-4348
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD60165770
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0266445
STATE L&I
WA
Enumeration date
07/22/2010
Last updated
11/02/2010
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