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Organization
COLUMBIA FOOT AND ANKLE CLINIC-VIRGIL GENE LIVINSTON
Active
Organization
COLUMBIA FOOT AND ANKLE CLINIC-VIRGIL GENE LIVINSTON
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. VIRGIL GENE LIVINGSTON MD-DPM (PHYSICIAN-PODIATRIST)
(602) 615-9915
Entity
Organization
Contact information
Practice address
12411 NE 70TH CIR STE 106, VANCOUVER, WA 98682-4885
(602) 615-9915
Mailing address
12411 NE 70TH CIR STE 106, VANCOUVER, WA 98682-4885
(602) 615-9915
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
—
NULL
213E00000X
Podiatrist
—
—
213EP1101X
Primary Podiatric Medicine Podiatrist
—
NULL
213EP1101X
Primary Podiatric Medicine Podiatrist
—
—
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
—
NULL
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2228399
—
WA
Enumeration date
11/10/2022
Last updated
12/07/2023
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