Jose Luis Diaz, MA6056739

NPI #1265815260 in Tumwater, Washington

Provider Information

NPI Number: 1265815260
Entity Type: Individual
Name: Jose Luis Diaz, MA6056739
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Specialist
Credential: MA6056739
Enumeration Date: Jul 8, 2015
Last Updated: Jul 8, 2015

Practice Location

Address: 2330 MOTTMAN RD SW
Address 2: SUITE 106
City: Tumwater
State: Washington
ZIP Code: 98512-6232
Phone: (360) 520-1917

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Specialist	174400000X	Primary

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