Individual
JULIO C. GONZALEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
413 LILLY RD NE, OLYMPIA, WA 98506
(360) 493-4083
Mailing address
PO BOX 3360, PORTLAND, OR 97208-3360
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD00038755
WA
207RI0200X
Infectious Disease Physician
MD00038755
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
079446
—
AZ
Enumeration date
05/22/2006
Last updated
05/18/2021
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