Individual
JOSEPHINE A WACHANA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
505 NE 87TH AVENUE, SUITE 200, VANCOUVER, WA 98664
(360) 256-8836
(360) 256-5024
Mailing address
9023 SE ASH, PORTLAND, OR 97216
(503) 408-4403
(360) 256-5024
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
PA60053259
WA
363AM0700X
Medical Physician Assistant
PA01272
OR
363AM0700X
Medical Physician Assistant
Primary
PA60053259
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
7736883
DRIVER LICENSE
OR
Enumeration date
11/11/2008
Last updated
12/04/2024
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