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Individual

IMELDA D. DE VILLA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
209 MARTIN LUTHER KING JR WAY, TACOMA, WA 98405-4265
(253) 596-3300
(253) 596-3301
Mailing address
209 MARTIN LUTHER KING JR WAY, TACOMA, WA 98405-4265
(253) 596-3300
(253) 596-3301

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD00045869
WA
207R00000X
Internal Medicine Physician
MD26369
ME

Other

Enumeration date
06/03/2006
Last updated
08/19/2022
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