Individual
ABRAHAM VELASCO BUSTAMANTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
1003 KOALA DR, OMAK, WA 98841-9247
(800) 660-2129
Mailing address
90 GOLDEN RD, OROVILLE, WA 98844-9766
(206) 639-5761
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
—
—
Other
Enumeration date
10/21/2024
Last updated
12/11/2024
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