Individual
MR. CONRADO FONTANILLA SAMPAYAN III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
4238 AUBURN WAY N, AUBURN, WA 98002-1311
(206) 901-2000
Mailing address
6400 SOUTHCENTER BLVD, TUKWILA, WA 98188-2547
(206) 901-2000
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
61475224
WA
Other
Enumeration date
09/25/2023
Last updated
09/25/2023
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