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Individual

ITTAY BERNARDO SANCHEZ I

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
19622 133RD AVENUE CT E, GRAHAM, WA 98338-8114
(253) 468-2880
Mailing address
19622 133RD AVENUE CT E, GRAHAM, WA 98338-8114
(253) 468-2280

Taxonomy

Speciality
Code
Description
License number
State
171R00000X
Interpreter
Primary
PMC15657
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
47-2682728
LABOR AND INDUSTRIES
WA
Enumeration date
01/26/2021
Last updated
01/26/2021
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