Individual
WAFIC A. MASSRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1003 S 5TH ST, TACOMA, WA 98405
(253) 403-2551
Mailing address
1003 S 5TH ST, TACOMA, WA 98405-4210
(253) 403-2551
Taxonomy
Speciality
Code
Description
License number
State
207VX0201X
Gynecologic Oncology Physician
Primary
MD45016
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000776266
ANTHEM
IN
05
—
177085101
—
TX
05
—
201076000
—
IN
01
—
8B4477
BCBS OF TEXAS
TX
01
—
P01170507
RR MEDICARE PTAN
IN
Enumeration date
10/05/2006
Last updated
09/07/2018
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