Individual
IAN BOJORQUEZ GILLINGHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
10510 GRAVELLY LAKE DR SW, LAKEWOOD, WA 98499-5036
(253) 589-7030
Mailing address
10510 GRAVELLY LAKE DR SW, LAKEWOOD, WA 98499-5036
(253) 589-7030
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD61144821
WA
207Q00000X
Family Medicine Physician
ML60979765
WA
Other
Enumeration date
04/10/2018
Last updated
02/14/2023
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