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Individual

DR. JOSEF EDRIK KEITH ABIOG BAUTISTA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
2707 COLBY AVE STE 718, EVERETT, WA 98201-3564
(425) 339-5413
(425) 339-4213
Mailing address
1840 E RAY RD, CHANDLER, AZ 85225-8720
(553) 970-1978
(800) 272-6512

Taxonomy

Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
MD15199
RI
207RN0300X
Nephrology Physician
Primary
MD61032416
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2157737
WA
Enumeration date
07/23/2012
Last updated
03/01/2021
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