Individual
OZONE GAUTAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2211 NE 139TH ST, VANCOUVER, WA 98686-2742
(360) 487-1168
(503) 413-7361
Mailing address
2211 NE 139TH ST, VANCOUVER, WA 98686-2742
(360) 487-1168
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
0101285256
VA
390200000X
Student in an Organized Health Care Education/Training Program
MDRE.ML.61299254
WA
Other
Enumeration date
06/19/2022
Last updated
07/15/2025
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