Individual
MICHAEL R TUCCIO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.A.
Contact information
Practice address
5633 N LIDGERWOOD ST, SPOKANE, WA 99208-1224
(509) 484-8069
(509) 462-4086
Mailing address
5633 N LIDGERWOOD ST, SPOKANE, WA 99208-1224
(509) 482-2448
(509) 482-2452
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
10003252
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8329724
—
WA
01
—
G000362000
MEDICARE GROUP
WA
Enumeration date
02/12/2007
Last updated
02/15/2011
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