Vancouver Primary Care Ps | |
11719 Ne 95th St Suite F Vancouver WA 98682-2444 | |
(360) 896-3188 | |
(360) 896-3122 |
Full Name | Vancouver Primary Care Ps |
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Speciality | Internal Medicine |
Location | 11719 Ne 95th St, Vancouver, Washington |
Authorized Official Name and Position | Steven Tonghua Lu (OWNER) |
Authorized Official Contact | 3608963188 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Vancouver Primary Care Ps 11719 Ne 95th St Suite F Vancouver WA 98682-2444 Ph: (360) 896-3188 | Vancouver Primary Care Ps 11719 Ne 95th St Suite F Vancouver WA 98682-2444 Ph: (360) 896-3188 |
NPI Number | 1538381884 |
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Provider Enumeration Date | 05/03/2007 |
Last Update Date | 05/30/2008 |
Medicare PECOS PAC ID | 3375536550 |
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Medicare Enrollment ID | O20040405000823 |
Identifier | Type | State | Issuer |
---|---|---|---|
1538381884 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | MD00040188 (Washington) | Primary |
Provider Name | Steven T Lu |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1679641344 PECOS PAC ID: 9638072408 Enrollment ID: I20040129000325 |
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