Provider Demographics
NPI:1932714466
Name:MUNOZ, NOE SALOMON (MC8648)
Entity Type:Individual
Prefix:
First Name:NOE
Middle Name:SALOMON
Last Name:MUNOZ
Suffix:
Gender:M
Credentials:MC8648
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4200 ROAD 100
Mailing Address - Street 2:
Mailing Address - City:PASCO
Mailing Address - State:WA
Mailing Address - Zip Code:99301-6537
Mailing Address - Country:US
Mailing Address - Phone:509-845-0339
Mailing Address - Fax:
Practice Address - Street 1:4200 ROAD 100
Practice Address - Street 2:
Practice Address - City:PASCO
Practice Address - State:WA
Practice Address - Zip Code:99301-6537
Practice Address - Country:US
Practice Address - Phone:509-845-0339
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-11
Last Update Date:2020-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMC8648171R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171R00000XOther Service ProvidersInterpreter