Provider Demographics
NPI:1639792112
Name:VIRAMONTES, SAMANTHA AUXILIO (MD)
Entity Type:Individual
Prefix:
First Name:SAMANTHA
Middle Name:AUXILIO
Last Name:VIRAMONTES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3901 NE 4TH ST STE 105
Mailing Address - Street 2:
Mailing Address - City:RENTON
Mailing Address - State:WA
Mailing Address - Zip Code:98056-4100
Mailing Address - Country:US
Mailing Address - Phone:425-690-3410
Mailing Address - Fax:425-690-9410
Practice Address - Street 1:3901 NE 4TH ST STE 105
Practice Address - Street 2:
Practice Address - City:RENTON
Practice Address - State:WA
Practice Address - Zip Code:98056-4100
Practice Address - Country:US
Practice Address - Phone:425-690-3410
Practice Address - Fax:425-690-9410
Is Sole Proprietor?:No
Enumeration Date:2020-05-19
Last Update Date:2023-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD61339197207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine