Individual
GEORGE MCLITUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2009 NE 117TH ST STE 101, VANCOUVER, WA 98686-4022
(360) 566-9112
Mailing address
2009 NE 117TH ST STE 101, VANCOUVER, WA 98686-4022
(360) 566-9112
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LP00044710
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1013051606
—
WA
Enumeration date
01/30/2018
Last updated
01/30/2018
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