Individual
COLE SOUTHWORTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
501 SE 172ND AVE, VANCOUVER, WA 98684
(360) 882-2778
(360) 604-1715
Mailing address
700 NE 87TH AVE, VANCOUVER, WA 98664-4896
(360) 882-2778
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
OP60828140
WA
Other
Enumeration date
05/22/2015
Last updated
08/06/2018
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