Individual
DR. OLOLADE SHUKURA LONGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
700 NE 87TH AVE STE 260, VANCOUVER, WA 98664
(360) 882-2778
Mailing address
PO BOX 4825, PORTLAND, OR 97208-4825
(360) 882-2778
(252) 744-0060
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD60948008
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2136164
—
WA
Enumeration date
05/11/2016
Last updated
09/17/2019
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