Individual
DR. GLENN AMANTE PACIO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
7501 92ND AVENUE CT SW, LAKEWOOD, WA 98498-3973
(253) 588-0058
(253) 589-4862
Mailing address
7501 92ND AVENUE CT SW, LAKEWOOD, WA 98498-3973
(253) 588-0058
(253) 589-4862
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD00038095
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1115922
—
WA
01
—
658809001
GROUP HEALTH
WA
01
—
P00183687
RAILROAD MEDICARE
—
Enumeration date
07/22/2005
Last updated
04/09/2015
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