LUKE MATTHEW REQUA

TACOMA, WA
NPI1922192954
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy363A00000X Physician Assistant
(Licence: WA  PA10004390)
Enumeration Date2006-10-03
Last Update Date2010-11-16
Business Address
-- LUKE MATTHEW REQUA PA-C
1717 S J ST
TACOMA, WA 98405-4933
Phone number: 253-426-6341
Mailing Address
-- LUKE MATTHEW REQUA PA-C
1717 S J ST
TACOMA, WA 98405-4933
Phone number: 253-426-6341