Individual
PAUL LEONID VINOGRADSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-S
Contact information
Practice address
1802 YAKIMA AVE STE 204, TACOMA, WA 98405-5304
(253) 382-8540
(253) 382-8545
Mailing address
1802 YAKIMA AVE STE 204, TACOMA, WA 98405-5304
(253) 382-8540
(253) 382-8545
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
PA61496599
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2271172
—
WA
Enumeration date
09/06/2022
Last updated
03/27/2024
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