| Vancouver Ear, Nose & Throat Head & Neck Surgery Clinic | |
|
1405 Se 164th Ave Suite 102 Vancouver WA 98683-9644 | |
| (360) 256-4425 | |
| (360) 256-2474 |
| Full Name | Vancouver Ear, Nose & Throat Head & Neck Surgery Clinic |
|---|---|
| Speciality | Clinic/center |
| Location | 1405 Se 164th Ave, Vancouver, Washington |
| Authorized Official Name and Position | Stephanie Hanks (PRACTICE MANAGER) |
| Authorized Official Contact | 3602564425 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Vancouver Ear, Nose & Throat Head & Neck Surgery Clinic 1405 Se 164th Ave Suite 102 Vancouver WA 98683-9644 Ph: (360) 256-4425 | Vancouver Ear, Nose & Throat Head & Neck Surgery Clinic 1405 Se 164th Ave Suite 102 Vancouver WA 98683-9644 Ph: (360) 256-4425 |
| NPI Number | 1780755876 |
|---|---|
| Provider Enumeration Date | 11/13/2006 |
| Last Update Date | 05/28/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1780755876 | NPI | - | NPPES |
| 7135486 | Medicaid | WA | |
| DF7194 | Other | WA | RAILROAD MEDICARE GROUP |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | 602 593 569 (Washington) | Primary |
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