Organization
BURDOIN MOUNTAIN MATERNITY CARE, PLLC
Active
Other names
Burdoin Mountain Medicine
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHARDONNAY JULIA VANCE MD, PHD (PHYSICIAN, OWNER)
(509) 289-2119
Entity
Organization
Contact information
Practice address
181 W JEWETT BLVD, WHITE SALMON, WA 98672-8974
(509) 289-2119
(509) 493-1264
Mailing address
PO BOX 886, WHITE SALMON, WA 98672-0886
(509) 289-2119
(509) 232-5809
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
—
—
251G00000X
Community Based Hospice Care Agency
—
—
251K00000X
Public Health or Welfare Agency
—
—
251V00000X
Voluntary or Charitable Agency
—
—
261Q00000X
Clinic/Center
Primary
—
—
261QB0400X
Birthing Clinic/Center
—
—
261QC1500X
Community Health Clinic/Center
—
—
261QP2300X
Primary Care Clinic/Center
—
—
261QR1300X
Rural Health Clinic/Center
—
—
261QU0200X
Urgent Care Clinic/Center
—
—
Other
Enumeration date
11/27/2018
Last updated
05/02/2019
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