Individual
MR. ALES MATZENAUER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
7511 CUSTER RD W, LAKEWOOD, WA 98499-8138
(253) 473-7303
(253) 473-7304
Mailing address
7511 CUSTER RD W, LAKEWOOD, WA 98499-8138
(253) 473-7303
(253) 473-7304
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD00026107
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0288165
STATE L&I
WA
05
—
1180082
—
WA
Enumeration date
08/16/2006
Last updated
02/06/2012
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