Individual
MARC-GREGORY WARHOLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
MADIGAN ARMY MEDICAL CTR 9040 JACKSON AVE, TACOMA, WA 98431-1100
(253) 968-5988
(253) 968-3278
Mailing address
MADIGAN ARMY MEDICAL CTR 9040 JACKSON AVE, TACOMA, WA 98431-1100
(253) 968-5988
(253) 968-3278
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
3678
AZ
363A00000X
Physician Assistant
Primary
60285461
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
328693
—
AZ
Enumeration date
12/16/2007
Last updated
08/18/2021
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