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Individual

JORGE L LLERA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1717 S J ST, TACOMA, WA 98405-4933
(253) 426-6963
(253) 838-6418
Mailing address
1717 S J ST, TACOMA, WA 98405-4933
(253) 426-6963
(253) 838-6418

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
MD00021285
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0171297
LIWA
WA
05
8609406
WA
01
LL3003
BSWA
WA
Enumeration date
05/26/2006
Last updated
01/09/2015
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