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Organization
VANCOUVER ENT AND ENT OF THE NORTHWEST PLLC
Active
Organization
VANCOUVER ENT AND ENT OF THE NORTHWEST PLLC
Active
Other names
Vancouver Ear, Nose & Throat Head & Neck Surgery Center
Organization subpart
No
Provider details
NPI number
Authorized official
MS. KAREN KENNEDY (PRACTICE MANAGER)
(360) 449-6612
Entity
Organization
Contact information
Practice address
14411 NE 20TH AVE STE 101, VANCOUVER, WA 98686-6432
(360) 256-4425
(360) 260-7249
Mailing address
1405 SE 164TH AVE STE 102, VANCOUVER, WA 98683-9644
(360) 256-4425
(360) 260-7249
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
204729
WA DEPT OF L&I
WA
05
—
7135502
—
WA
01
—
8940474
WA CRIME VICTIMS
WA
Enumeration date
10/12/2006
Last updated
10/29/2007
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