Individual
MARK VANDERVORT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
4280 MERIDIAN ST, STE 120, BELLINGHAM, WA 98226-6464
(360) 734-4300
Mailing address
4280 MERIDIAN ST, STE 120, BELLINGHAM, WA 98226-6464
(360) 734-4300
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
60055369
WA
Other
Enumeration date
09/21/2007
Last updated
10/21/2009
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