Bautista, Andre Barranda
Bautista, Andre Barranda is an individual health care provider with primary practice located at 2502 S Union Ave , Tacoma WA 98405-1328. He recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Diagnostic Radiology, Student, Health Care / Student in an Organized Health Care Education/Training Program, Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology. Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology is his primary health care specialty. Bautista, Andre Barranda can be contacted via phone (253) 841-4653.Contact Information
Primary practice address
2502 S Union Ave
Tacoma WA 98405-1328
Phone: (253) 841-4653
Fax: (253) 446-3973
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Diagnostic Radiology | 2085R0202X | MD60545139 | Washington |
| Student, Health Care / Student in an Organized Health Care Education/Training Program | 390200000X | ||
| Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology | 2085R0204X | MD60545139 | Washington |
Profile Details
| NPI number | 1164665444 |
|---|---|
| LBN Legal business name | Bautista, Andre Barranda |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Apr 15th, 2009 |
| Last updated | Apr 25th, 2024 - about last year |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1164665444 | NPPES |
| Washington | MEDICAID | 2044117 |
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