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Individual

DR. MONICA E. DE BACA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
4121 48TH AVE S, SEATTLE, WA 98118-1225
(206) 218-7788
Mailing address
4121 48TH AVE S, SEATTLE, WA 98118-1225
(206) 218-7788

Taxonomy

Speciality
Code
Description
License number
State
207ZP0101X
Anatomic Pathology Physician
Primary
MD423639
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
399365500
MN
Enumeration date
05/16/2006
Last updated
10/08/2014
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