# VANCOUVER ENT AND ENT OF THE NORTHWEST PLLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Vancouver Ear, Nose & Throat Head & Neck Surgery Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1265527162
- **Authorized official:** MR. NATHAN J GEIGLE (PRACTICE MANAGER)
- **Authorized official phone:** (360) 449-6612

## Contact information

- **Practice address:** 1405 SE 164TH AVE STE 102, VANCOUVER, WA 98683-9644
- **Practice address phone:** (360) 256-4425
- **Practice address fax:** (360) 260-7249
- **Mailing address:** 1405 SE 164TH AVE STE 102, VANCOUVER, WA 98683-9644
- **Mailing address phone:** (360) 256-4425
- **Mailing address fax:** (360) 260-7249

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QA1903X | Ambulatory Surgical Clinic/Center | — | WA | Yes |

## Other

- **Enumeration date:** 10/04/2006
- **Last updated:** 07/23/2007

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 15018260 | REGENCE FIRST CHOICE 65 | WA |
| 01 | — | 169197 | WA DEPT OF L&I | WA |
| 05 | — | 7135502 | — | WA |
| 01 | — | 8933204 | WA CRIME VICTIMS | WA |