Healthcare Provider Details

I. General information

NPI: 1679804652
Provider Name (Legal Business Name): MATIAS CUITINO INTERPRETER
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/15/2010
Last Update Date: 04/24/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5020 NE 48TH ST
VANCOUVER WA
98661-2976
US

IV. Provider business mailing address

5020 NE 48TH ST
VANCOUVER WA
98661-2976
US

V. Phone/Fax

Practice location:
  • Phone: 503-926-3424
  • Fax:
Mailing address:
  • Phone: 503-926-3424
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171R00000X
TaxonomyInterpreter
License NumberMC13751
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: