Individual
CARLOS E VILLAVICENCIO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4800 SAND POINT WAY NE, SEATTLE, WA 98105-3901
(206) 987-2000
Mailing address
PO BOX 50010, SEATTLE, WA 98105-1010
(206) 987-8450
(206) 987-8484
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
MD00044735
WA
208M00000X
Hospitalist Physician
Primary
MD00044735
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8423816
—
WA
Enumeration date
01/09/2007
Last updated
09/18/2018
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