Individual
MS. MARISA OSORIO GHOLSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
210 SE 136TH AVE, VANCOUVER, WA 98684-6930
(360) 944-9889
Mailing address
1498 SE TECH CENTER PL STE 240, VANCOUVER, WA 98683-5508
(512) 649-9095
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
PA179365
OR
363A00000X
Physician Assistant
Primary
PA60734980
WA
Other
Enumeration date
05/11/2015
Last updated
03/17/2018
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