MOON V TINAJERO-SIMMALY

VANCOUVER, WA
NPI1295330694
Former NameKATHERINE TINAJERO
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy363A00000X Physician Assistant
(Licence: WA  PA61511235)
Additional Taxonomies363A00000X Physician Assistant
(Licence: NV  PA2358)
363A00000X Physician Assistant
(Licence: CA  58655)
Enumeration Date2020-12-02
Last Update Date2024-04-30
Business Address
Mrs. MOON V TINAJERO-SIMMALY PA-C
2101 NE 139TH ST STE 460
VANCOUVER, WA 98686-2325
Phone number: 360-487-2727
Mailing Address
Mrs. MOON V TINAJERO-SIMMALY PA-C
PO BOX 2077
PORTLAND, OR 97208-2077
Phone number: 503-413-3900