Individual
MR. WINSTON CARREON BALANGUE I
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3209 S 23RD ST, TACOMA, WA 98405-1602
(253) 501-2254
Mailing address
17425 161ST AVE SE, RENTON, WA 98058-9142
(206) 473-0854
Taxonomy
Speciality
Code
Description
License number
State
156F00000X
Technician/Technologist
Primary
—
—
Other
Enumeration date
01/25/2021
Last updated
01/25/2021
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