Individual
JAIRO ENRIGUE MENDOZA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1620 COOPER POINT RD SW, OLYMPIA, WA 98502-5736
(360) 486-6710
(360) 705-0269
Mailing address
PO BOX 3360, PORTLAND, OR 97208-3360
(360) 493-4180
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD61469474
WA
Other
Enumeration date
05/22/2020
Last updated
08/30/2023
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