Individual
CRYSTAL VIDAL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
9040 JACKSON AVE, TACOMA, WA 98431-0001
(253) 968-6288
Mailing address
9040 JACKSON AVE, TACOMA, WA 98431-0001
Taxonomy
Speciality
Code
Description
License number
State
163WC0400X
Case Management Registered Nurse
Primary
RN60010948
WA
Other
Enumeration date
03/12/2019
Last updated
03/12/2019
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