Provider Demographics
NPI:1346883949
Name:RAMOS GONZALEZ, NILDA LIZ (DC)
Entity Type:Individual
Prefix:
First Name:NILDA
Middle Name:LIZ
Last Name:RAMOS GONZALEZ
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6105 FAWCETT AVE
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98408-6329
Mailing Address - Country:US
Mailing Address - Phone:787-449-9486
Mailing Address - Fax:
Practice Address - Street 1:6105 FAWCETT AVE
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98408-6329
Practice Address - Country:US
Practice Address - Phone:787-449-9486
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-10-26
Last Update Date:2019-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACHIR.CH.60951602111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor