Individual
JOANNA MARIE F POLISTICO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
7210 40TH ST W STE 100, UNIVERSITY PLACE, WA 98466-4319
(253) 564-0170
(253) 274-4599
Mailing address
7210 40TH ST W STE 100, UNIVERSITY PLACE, WA 98466-4319
(253) 564-0170
(253) 274-4599
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
036132409
IL
207Q00000X
Family Medicine Physician
Primary
MD60672297
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2071930
—
WA
Enumeration date
06/21/2010
Last updated
12/08/2020
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