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Individual

SON T DO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
2415 NE 134TH ST, SUITE 205, VANCOUVER, WA 98686-3025
(360) 576-5060
Mailing address
2415 NE 134TH ST, SUITE 205, VANCOUVER, WA 98686-3025
(360) 576-5060

Taxonomy

Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
MD00042129
WA
207RG0100X
Gastroenterology Physician
MD182143
OR

Other

Enumeration date
07/10/2006
Last updated
10/01/2025
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