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Individual Provider (NPI-1)
Active
Licensed Practical Nurse
Provider Information
- NPI Number
1770113052- Provider Type
- Individual Provider (NPI-1)
- Status
- Active
Contact & Location
- Address
- 2009 NE 117TH ST STE 101, VANCOUVER, WA, 986864022
- Phone
- (360) 566-9112
- Fax
- (360) 566-9133
Specialties & Taxonomies
Licensed Practical Nurse
Primary License: OR #201501677LPN
All Addresses
MAILING
16512 NE 27TH WAY
VANCOUVER, WA, 986849818