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Individual

HANS ALBERT QUISTORFF

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LMP

Contact information

Practice address
13414 138TH AVENUE KP N, GIG HARBOR, WA 98329-5303
(253) 851-4212
Mailing address
PO BOX 65, WAUNA, WA 98395-0065
(253) 851-4212

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MA OOOO8159
WA

Other

Enumeration date
01/27/2009
Last updated
01/27/2009
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