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Individual

DR. PRUDENCIO GALVEZ TIBLE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
5023 S BARTON PLACE, SEATTLE, WA 98118
(206) 725-8043
(206) 760-1359
Mailing address
PO BOX 18936, SEATTLE, WA 98118
(206) 725-8043
(206) 760-1359

Taxonomy

Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
MD00022189
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1035013
WA
Enumeration date
10/16/2006
Last updated
07/08/2007
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