Healthcare Provider Details

I. General information

NPI: 1306044268
Provider Name (Legal Business Name): ARMANDO GARZA I.D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/03/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2000 W MARINE VIEW DR
EVERETT WA
98207-0001
US

IV. Provider business mailing address

11030 EVERGREEN WAY APT B420
EVERETT WA
98204-3897
US

V. Phone/Fax

Practice location:
  • Phone: 425-304-4066
  • Fax:
Mailing address:
  • Phone: 425-304-4066
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1710I1002X
TaxonomyIndependent Duty Corpsman
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: