Individual
ELIJAH MATTHEW HILLSTROM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
C.PED
Contact information
Practice address
4903 NE ST JOHNS RD, VANCOUVER, WA 98661-2546
(360) 635-8079
(360) 450-2236
Mailing address
3816 NE 38TH AVE, VANCOUVER, WA 98661-3426
(360) 635-8079
(360) 450-2236
Taxonomy
Speciality
Code
Description
License number
State
224L00000X
Pedorthist
Primary
CPED3653
WA
Other
Enumeration date
01/24/2013
Last updated
01/24/2013
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