Individual
LIZETTE JAMORA ANTIG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
875 WESLEY ST STE 130, ARLINGTON, WA 98223
(360) 435-6525
(360) 435-2634
Mailing address
1400 E KINCAID STREET, ATTN: CREDENTIALING, MOUNT VERNON, WA 98274-4127
(360) 428-2500
(360) 428-6485
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
MD60864132
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2115351
—
WA
01
—
400219
LABOR & INDUSTRIES
WA
Enumeration date
04/16/2015
Last updated
10/22/2021
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