Individual
MIA DANIELLE DEBARROS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
9040 JACKSON AVENUE, JOINT BASE LEWIS MCCHORD, WA 98431-1000
(253) 968-2200
Mailing address
9040 JACKSON AVENUE, JOINT BASE LEWIS MCCHORD, WA 98431-1000
(253) 968-2200
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
26423
NE
208600000X
Surgery Physician
MD60666886
WA
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
MD60666886
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2033450
—
WA
01
—
26423
MEDICAL LICENSE
NE
01
—
278192
MEDICAL LICENSE
MA
01
—
60666886
MEDICAL LICENSE
WA
Enumeration date
01/29/2010
Last updated
11/24/2023
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