Individual
DR. NINA SOFIA UPHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2525 NE 139TH ST, VANCOUVER, WA 98686-2719
(360) 882-2778
Mailing address
700 NE 87TH AVE, VANCOUVER, WA 98664-1913
(360) 882-2778
Taxonomy
Speciality
Code
Description
License number
State
207QS0010X
Sports Medicine (Family Medicine) Physician
Primary
60278739
WA
207RS0010X
Sports Medicine (Internal Medicine) Physician
MD60278739
WA
Other
Enumeration date
04/10/2008
Last updated
01/22/2013
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