Individual
JOSEPH MANGUNARY VICTORIO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MOT / OTR / L
Contact information
Practice address
1660 COLUMBIAN WAY SOUTH, SEATTLE, WA 98144
(206) 762-1010
Mailing address
6247 CARSON HILLS AVE, LAS VEGAS, NV 89139
(702) 412-9171
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
0763
NV
225X00000X
Occupational Therapist
1064302
MD
225X00000X
Occupational Therapist
13362
CA
Other
Enumeration date
09/13/2012
Last updated
09/18/2014
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