Organization
RAFAEL MEDICUS CLINIC, CORP.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GLENN NOEL PADILLA RUIZ (PRESIDENT)
(253) 474-5141
Entity
Organization
Contact information
Practice address
7424 BRIDGEPORT WAY WEST, SUITE 301, LAKEWOOD, WA 98499-8135
(253) 474-5141
(253) 474-5507
Mailing address
7424 BRIDGEPORT WAY WEST, SUITE 301, LAKEWOOD, WA 98499-8135
(253) 474-5141
(253) 474-5507
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD00024942
WA
Other
Enumeration date
05/18/2016
Last updated
05/18/2016
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