Individual
EDUARDO JIMENEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2121 S 19TH ST, TACOMA, WA 98405-2922
(253) 280-9830
Mailing address
2121 S 19TH ST, TACOMA, WA 98405-2922
(253) 280-9830
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
CG60697933
WA
Other
Enumeration date
11/20/2018
Last updated
11/20/2018
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