Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207L00000X | Anesthesiologist | MD60866664 | WA |
NPI | 1013123884 |
---|---|
Provider Name | Dr. Ramon Larios |
First Address | Vancouver, WA 98664-1988 |
Second Address | Vancouver, WA 98664-3200 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/05/2007 |
Last Update Date | 26/12/2018 |