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ORVILLE KEITH VANDERGRIEND

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
3104 SQUALICUM PKWY, SUITE 101, BELLINGHAM, WA 98225-1941
(360) 733-2557
(360) 733-4674
Mailing address
3104 SQUALICUM PKWY, SUITE 101, BELLINGHAM, WA 98225-1941
(360) 733-2557
(360) 733-4674

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
10361
WA
208600000X
Surgery Physician
Primary
MD00010361
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0146VA
REGENCE BLUE SHIELD (PEACEHEALTH)
WA
05
1069509
WA
05
1073662508
WA
01
82107
CRIME VICTIMS (PEACEHEALTH)
WA
Enumeration date
01/10/2007
Last updated
01/24/2013
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