Organization
VANNVEI LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TERESA GALL (CFO)
(509) 758-5511
Entity
Organization
Contact information
Practice address
1221 HIGHLAND AVE, CLARKSTON, WA 99403
(509) 758-5511
(509) 721-9406
Mailing address
PO BOX 341, LEWISTON, ID 83501-0341
(509) 758-3311
(509) 751-9406
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
H108
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003110900
—
ID
Enumeration date
12/05/2006
Last updated
01/26/2021
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