Individual
JUSTIN FERNANDO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
15100 SE 38TH ST, BELLEVUE, WA 98006-1728
(425) 746-4028
Mailing address
15100 SE 38TH ST, BELLEVUE, WA 98006-1728
(425) 746-4028
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
60596660
WA
Other
Enumeration date
11/13/2016
Last updated
11/13/2016
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