Individual
TONI LUCILLE STORM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
210 SE 136TH AVE, VANCOUVER, WA 98684-6930
(360) 944-9889
(360) 944-9686
Mailing address
210 SE 136TH AVE, VANCOUVER, WA 98684-6930
(360) 944-9889
(360) 944-9686
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
MD00042022
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1036230
—
WA
05
—
275562
—
OR
Enumeration date
10/03/2006
Last updated
01/14/2021
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