Individual
JOSE ANGEL DIAZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA C
Contact information
Practice address
716 E MANITOBA AVE, ELLENSBURG, WA 98926-3842
(509) 933-8777
Mailing address
716 E MANITOBA AVE, ELLENSBURG, WA 98926-3842
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA10004545
WA
Other
Enumeration date
11/11/2005
Last updated
06/06/2016
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