Individual
FABIOLA ELOISA PUGA DUENAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
521 ADAMS AVE STE B, MORTON, WA 98356-9323
(360) 496-5145
Mailing address
PO BOX 1138, MORTON, WA 98356-0019
(360) 496-5112
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD61230186
WA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/18/2019
Last updated
02/01/2024
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