Individual
MR. SAMUEL LOPEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
203 SE PARK PLAZA DR STE 140, VANCOUVER, WA 98684-5887
(800) 813-2000
Mailing address
203 SE PARK PLAZA DR STE 140, VANCOUVER, WA 98684-5887
(800) 813-2000
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
PA156712
OR
363AS0400X
Surgical Physician Assistant
Primary
PAL-3102
CO
Other
Enumeration date
02/23/2009
Last updated
03/06/2022
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