| Lane Van Der Sluis Inc Ps | |
|
756 Officers Row Vancouver WA 98661-3845 | |
| (360) 695-8332 | |
| (866) 524-1569 |
| Full Name | Lane Van Der Sluis Inc Ps |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 756 Officers Row, Vancouver, Washington |
| Authorized Official Name and Position | Lane Van Der Sluis (PRESIDENT) |
| Authorized Official Contact | 3606958332 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lane Van Der Sluis Inc Ps Po Box 213 La Center WA 98629-0213 Ph: (360) 695-8332 | Lane Van Der Sluis Inc Ps 756 Officers Row Vancouver WA 98661-3845 Ph: (360) 695-8332 |
| NPI Number | 1437485679 |
|---|---|
| Provider Enumeration Date | 10/22/2009 |
| Last Update Date | 10/22/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1437485679 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | PY00001784 (Washington) | Primary |
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