| Providence Neurological Specialties Mill Plain | |
|
315 Se Stonemill Dr Suite 220 Vancouver WA 98684-6987 | |
| (503) 717-7147 | |
| Not Available |
| Full Name | Providence Neurological Specialties Mill Plain |
|---|---|
| Speciality | Clinic/center |
| Location | 315 Se Stonemill Dr, Vancouver, Washington |
| Authorized Official Name and Position | Donald W Anderson (DIR REIMB REG STRAT/ASST SEC ENROLL) |
| Authorized Official Contact | 4255255392 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Providence Neurological Specialties Mill Plain Po Box 3158 Portland OR 97208-3158 Ph: () - | Providence Neurological Specialties Mill Plain 315 Se Stonemill Dr Suite 220 Vancouver WA 98684-6987 Ph: (503) 717-7147 |
| NPI Number | 1336543560 |
|---|---|
| Provider Enumeration Date | 10/17/2014 |
| Last Update Date | 01/15/2021 |
| Certification Date | 01/15/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1336543560 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | (* (Not Available)) | Secondary |
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
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