Individual
JOAQUIN ALDAIR LIZAOLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1802 YAKIMA AVE STE 204, TACOMA, WA 98405-5304
(253) 627-1244
(253) 627-6576
Mailing address
1802 YAKIMA AVE STE 204, TACOMA, WA 98405-5304
(253) 627-1244
(253) 627-6576
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
61366189
WA
363A00000X
Physician Assistant
Primary
PA61366189
WA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2229453
—
WA
Enumeration date
07/22/2021
Last updated
03/06/2023
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