Individual
MR. MARTIN JOSE LOPEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.A.
Contact information
Practice address
5304 N ROAD 68, PASCO, WA 99301-9189
(509) 543-9300
Mailing address
6207 COWLITZ LN, PASCO, WA 99301-6760
(509) 547-2607
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
OA10000117
WA
Other
Enumeration date
03/07/2007
Last updated
07/08/2007
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