# COLUMBIA FOOT AND ANKLE CLINIC-VIRGIL GENE LIVINSTON

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1326756180
- **Authorized official:** DR. VIRGIL GENE LIVINGSTON MD-DPM (PHYSICIAN-PODIATRIST)
- **Authorized official phone:** (602) 615-9915

## Contact information

- **Practice address:** 12411 NE 70TH CIR STE 106, VANCOUVER, WA 98682-4885
- **Practice address phone:** (602) 615-9915
- **Mailing address:** 12411 NE 70TH CIR STE 106, VANCOUVER, WA 98682-4885
- **Mailing address phone:** (602) 615-9915

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 213E00000X | Podiatrist | — | NULL | — |
| 213E00000X | Podiatrist | — | — | — |
| 213EP1101X | Primary Podiatric Medicine Podiatrist | — | NULL | — |
| 213EP1101X | Primary Podiatric Medicine Podiatrist | — | — | — |
| 213ES0103X | Foot & Ankle Surgery Podiatrist | — | NULL | Yes |
| 213ES0103X | Foot & Ankle Surgery Podiatrist | — | — | Yes |

## Other

- **Enumeration date:** 11/10/2022
- **Last updated:** 12/07/2023

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 2228399 | — | WA |