Individual
MATTHEW GERVAIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
AIRMENS CLINIC, BUILDING 690, TACOMA, WA 98431
(253) 982-5688
Mailing address
AIRMENS CLINIC, BUILDING 690, TACOMA, WA 98431
(253) 982-5688
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
36542
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
689263900
—
MN
Enumeration date
12/07/2005
Last updated
05/05/2014
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