Individual
ELISHA MVUNDURA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1000 S SCHEUBER RD, CENTRALIA, WA 98531-8877
(360) 330-8950
Mailing address
PO BOX 3360, PORTLAND, OR 97208-3360
(360) 330-8950
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
MD00048832
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0-644-431-9
ECFMG
—
Enumeration date
06/02/2008
Last updated
06/23/2021
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