Individual
JOEL FAUSTO KLIATCHKO ESTRADA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1701 3RD ST SE, SUITE 300, PUYALLUP, WA 98372-4511
(253) 697-5767
(253) 697-5682
Mailing address
PO BOX 34703, SEATTLE, WA 98124-1703
(206) 764-0112
(206) 764-0489
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD00041954
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8370488
—
WA
Enumeration date
01/19/2007
Last updated
11/03/2011
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