Individual
FEDERICO FENTON PORTILLO
Active
Individual
FEDERICO FENTON PORTILLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD60639341
WA
207R00000X
Internal Medicine Physician
R-9606
IA
208M00000X
Hospitalist Physician
MD60639341
WA
Other
Enumeration date
07/07/2013
Last updated
03/29/2021
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