Individual
JOHN TIMOTHY DANIEL ALTAMIRA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
27023 164TH AVE SE, COVINGTON, WA 98042-8241
(253) 639-7146
Mailing address
27023 164TH AVE SE, COVINGTON, WA 98042-8241
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
CB60996468
WA
Other
Enumeration date
10/10/2019
Last updated
10/10/2019
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