Individual
DR. RACHELLE VICENCIO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1608 S J ST, FLOOR 2, TACOMA, WA 98405-4930
(253) 274-7503
(253) 274-7993
Mailing address
1608 S J ST, FLOOR 2, TACOMA, WA 98405-4930
(253) 274-7503
(253) 274-7993
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
8456A
WY
208000000X
Pediatrics Physician
Primary
MD60580586
WA
Other
Enumeration date
08/14/2007
Last updated
11/25/2015
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