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Individual

GOVANNI GIL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
3510 STEELHAMMER DR, CENTRALIA, WA 98531-4551
(360) 623-8020
Mailing address
3510 STEELHAMMER DR, CENTRALIA, WA 98531-4551
(360) 623-8020

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
CG60877399
WA
Enumeration date
06/19/2019
Last updated
06/19/2019
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