Individual
SELWYNE JEI C. MATILLANO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
22870 SE FIR ST APT J202, BLACK DIAMOND, WA 98010-5147
(808) 359-1920
Mailing address
22870 SE FIR ST APT J202, BLACK DIAMOND, WA 98010-5147
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
61300874
WA
Other
Enumeration date
09/29/2022
Last updated
09/29/2022
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