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Individual

JOHN JAY MARCELO MERCADO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
8760 GREENWOOD AVE N APT N502, SEATTLE, WA 98103-3678
(361) 537-9464
Mailing address
8760 GREENWOOD AVE N APT N502, SEATTLE, WA 98103-3678
(361) 537-9464

Taxonomy

Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
P160668651
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
709350
PROFESSIONAL ORGANIZATION
Enumeration date
04/11/2022
Last updated
04/11/2022
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