Provider Demographics
NPI:1306308283
Name:CANDIDO, CAMILLO (MD)
Entity type:Individual
Prefix:DR
First Name:CAMILLO
Middle Name:
Last Name:CANDIDO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:CAM
Other - Middle Name:
Other - Last Name:CANDIDO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:4200 MARY GATES MEMORIAL DR NE APT V259
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98105-5659
Mailing Address - Country:US
Mailing Address - Phone:360-229-2834
Mailing Address - Fax:
Practice Address - Street 1:4200 MARY GATES MEMORIAL DR NE APT V259
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98105-5659
Practice Address - Country:US
Practice Address - Phone:360-229-2834
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-01
Last Update Date:2019-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program