# VIRGINIA R CANNON MD PLLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** West Olympia Bone Density Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1144402009
- **Authorized official:** DR. VIRGINIA R CANNON M.D, (OWNER)
- **Authorized official phone:** (360) 352-3232

## Contact information

- **Practice address:** 406 YAUGER WAY SW, SUITE A, OLYMPIA, WA 98502-8151
- **Practice address phone:** (360) 352-3232
- **Practice address fax:** (360) 352-2942
- **Mailing address:** 406 YAUGER WAY SW, SUITE A, OLYMPIA, WA 98502-8151
- **Mailing address phone:** (360) 352-3232
- **Mailing address fax:** (360) 352-2942

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207RA0000X | Adolescent Medicine (Internal Medicine) Physician | — | NULL | Yes |
| 207RA0000X | Adolescent Medicine (Internal Medicine) Physician | — | — | Yes |

## Other

- **Enumeration date:** 12/03/2007
- **Last updated:** 10/29/2010