Individual
DEBRA LYNN FORDHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
R.N.
Contact information
Practice address
615 W 39TH ST, VANCOUVER, WA 98660-1854
(360) 606-2191
Mailing address
615 W 39TH ST, VANCOUVER, WA 98660-1854
(360) 606-2191
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN00149046
WA
Other
Enumeration date
04/23/2013
Last updated
04/23/2013
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