Individual
JESUS ANTONIO BAUTISTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1601 E COLLEGE WAY, MOUNT VERNON, WA 98273-5612
(360) 848-8437
(360) 848-5250
Mailing address
1601 E COLLEGE WAY, MOUNT VERNON, WA 98273-5612
(360) 848-8437
(360) 848-5250
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
03/16/2018
Last updated
03/16/2018
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