Individual
ABDIEL A CERVANTES I
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
214 ASH ST, GRANDVIEW, WA 98930-1319
(509) 203-0959
Mailing address
2004 WYANT WAY, GRANDVIEW, WA 98930-1100
(509) 203-0959
Taxonomy
Speciality
Code
Description
License number
State
171R00000X
Interpreter
Primary
MC53055
WA
Other
Enumeration date
04/15/2021
Last updated
04/15/2021
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