Organization
GREAT WEST FAMILY CARE PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. REBECCA L HOFFMAN MD (PRESIDENT)
(360) 574-9730
Entity
Organization
Contact information
Practice address
14508 NE 20TH AVE, SUITE 102, VANCOUVER, WA 98686-6434
(360) 574-9730
(360) 576-7662
Mailing address
14508 NE 20TH AVE, SUITE 102, VANCOUVER, WA 98686-6434
(360) 574-9730
(360) 576-7662
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
602202713
WA
261QP2300X
Primary Care Clinic/Center
Primary
602202713
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7124530
—
WA
Enumeration date
07/13/2006
Last updated
12/29/2008
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