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1104680032
ALEXANDER DE LA RIVA FUENTES
TACOMA, WA
NPI
1104680032
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
171000000X Military Health Care Provider
Enumeration Date
2024-02-12
Last Update Date
2024-02-12
Business Address
ALEXANDER DE LA RIVA FUENTES
9040 JACKSON AVE
TACOMA, WA 98431-0001
Phone number: 253-968-3066
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Mailing Address
ALEXANDER DE LA RIVA FUENTES
9040 JACKSON AVE
TACOMA, WA 98431-0001
Phone number: 253-968-3066
Copy
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