Organization
ASSOCIATED VALLEY PROVIDERS PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN L VANDERHEYDEN M.D. (OWNER)
(425) 255-5111
Entity
Organization
Contact information
Practice address
4361 TALBOT RD S, SUITE 112, RENTON, WA 98055-6226
(425) 255-5111
(425) 254-0985
Mailing address
4361 TALBOT RD S, SUITE 112, RENTON, WA 98055-6226
(425) 255-5111
(425) 254-0985
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
WA
207V00000X
Obstetrics & Gynecology Physician
—
WA
213ES0103X
Foot & Ankle Surgery Podiatrist
—
WA
363L00000X
Nurse Practitioner
—
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7112634
—
WA
Enumeration date
11/13/2007
Last updated
09/22/2009
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