Individual
RENATO VERANO FAJARDO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
34616 11TH PL S, #3, FEDERAL WAY, WA 98003-8705
(253) 874-5148
(253) 874-4228
Mailing address
34616 11TH PL S STE 3, FEDERAL WAY, WA 98003-8705
(253) 874-5148
(253) 874-4228
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
30962
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
124708
LI
—
Enumeration date
09/09/2005
Last updated
04/11/2014
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