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Ma Portia Bernadette Guce Domingo, DO
Student in an Organized Health Care Education/Training Program in Mount Vernon, Washington
NPI 1700573722

Ma Portia Bernadette Guce Domingo is a Student in an Organized Health Care Education/Training Program based in Mount Vernon, WA. Ma Portia Bernadette Guce Domingo practices in Mount Vernon, WA and has the professional credentials of DO. The NPI Number for Ma Portia Bernadette Guce Domingo is 1700573722 and holds a License No. OL61440780 (Washington).

The current practice location address for Ma Portia Bernadette Guce Domingo is 819 S 13Th St, Mount Vernon, WA and can be reached out via phone at 360-814-6230. You can also correspond with Ma Portia Bernadette Guce Domingo through the mailing address at 1400 E KINCAID ST, MOUNT VERNON, WA - 98274-4127 (mailing address contact number: ).

Location: 819 S 13Th St, Mount Vernon, WA, 98274-4127
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1700573722
Provider Name
Ma Portia Bernadette Guce Domingo
Credential
DO
Provider Entity Type
Individual
Gender
Female
Address
819 S 13Th St, Mount Vernon, WA, 98274-4127
Phone Number
360-814-6230
Fax Number
Provider Enumeration Date
04/19/2023
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
819 S 13Th St
City
Mount Vernon
State
Washington
Zip
98274-4112
Phone Number
360-814-6230
Fax Number
person
Provider Business Mailing Address Details
Address
819 S 13Th St
City
Mount Vernon
State
Washington
Zip
98274-4112
Phone Number
360-814-6230
Fax Number
person
Provider's Taxonomy Details 1
Type
Student, Health Care
Classification
Student in an Organized Health Care Education/Training Program
Speciality
-
Taxonomy
390200000X
License No.
OL61440780 (Washington)
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
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