Individual
DR. OVIDIO MOISES PENALVER
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
MD, PS
Contact information
Practice address
319 5TH ST SW, PUYALLUP, WA 98371-5828
(253) 848-0351
(253) 841-1397
Mailing address
319 5TH ST SW, PUYALLUP, WA 98371-5828
(253) 848-0351
(253) 841-1397
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MD00015660
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7110653
—
WA
Enumeration date
06/21/2005
Last updated
07/08/2007
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