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Individual

FORTUNATO PLACENCIA JR.

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
6808 220TH ST SW STE 201, MOUNTLAKE TERRACE, WA 98043-2187
(425) 640-6976
Mailing address
427 MISSION AVE, CASHMERE, WA 98815-1052
(509) 881-4395

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
WA

Other

Enumeration date
08/29/2025
Last updated
08/29/2025
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