Individual
DR. LEWIS A VANOSDEL III
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1033 SW 152ND ST, NAVOS SUNSTONE YOUTH RESIDENTIAL, BURIEN, WA 98166
(206) 829-1121
Mailing address
11602 SW BREYMAN AVE, PORTLAND, OR 97219-8400
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
G33962
CA
2084P0802X
Addiction Psychiatry Physician
9213117-1205
UT
2084P0804X
Child & Adolescent Psychiatry Physician
G-33962
CA
2084P0804X
Child & Adolescent Psychiatry Physician
MD00033116
WA
Other
Enumeration date
01/19/2007
Last updated
01/17/2020
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