NPI 1205230489

Mazimo Azucena Afh

Organisation Exclusive Provider Organization Everett, WA

Practice location

Address: 10522 19th Pl W, Everett, WA 98204-3663
Phone: (425) 322-5328
Fax: (425) 322-5328

Authorised official

Name: Maximo Dimaunahan Azucena
Title: Provider
Phone: (425) 322-5328

Registered specialties

Exclusive Provider Organization Primary

Managed Care Organizations Taxonomy 302F00000X Licence 751038 (WA)

Other Exclusive Provider Organization providers in Washington →

Registry record

NPI: 1205230489
Entity type: Organization
NPI issued: 16 Oct 2014
Record last updated: 16 Oct 2014

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.