Individual
CARLOS A. VIGIL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.A.
Contact information
Practice address
209 MARTIN LUTHER KING JR WAY, TACOMA, WA 98405-4265
(253) 596-3300
Mailing address
209 MARTIN LUTHER KING JR WAY, TACOMA, WA 98405-4265
(253) 596-3300
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
PA10003501
WA
363AS0400X
Surgical Physician Assistant
Primary
PA10003501
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8343337
—
WA
Enumeration date
01/02/2007
Last updated
05/10/2021
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