Most Relevant Information
Provider Data
| NPI Number: | 1003502303 |
| Provider Name: | ANDREW MYLES TAGLE DO |
| Entity Type: | Individual |
| Taxonomy Code: | 390200000X |
| Specialty: | Student in an Organized Health Care Education/Training Program |
| License Number: | OL61434148 |
Most Important Dates
| Enumeration Date: | 04/11/2023 |
| Last Updated: | 07/10/2023 |
Provider Practice Location
819 S 13TH ST
MOUNT VERNON
WA
982744112
Practice Location Phone/Fax
| Phone: | 3608146230 |
| Fax: |
Provider Mailing Location
819 S 13TH ST
MOUNT VERNON
WA
982744112
Provider Mailing Phone/Fax
| Phone: | 3608146230 |
| Fax: |