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1003502303
ANDREW MYLES TAGLE
MOUNT VERNON, WA
NPI
1003502303
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
390200000X Student in an Organized Health Care Education/Training Program
(Licence: WA OL61434148)
Enumeration Date
2023-04-11
Last Update Date
2023-07-10
Business Address
ANDREW MYLES TAGLE DO
819 S 13TH ST
MOUNT VERNON, WA 98274-4112
Phone number: 360-814-6230
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Mailing Address
ANDREW MYLES TAGLE DO
819 S 13TH ST
MOUNT VERNON, WA 98274-4112
Phone number: 360-814-6230
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