Organization
VANCOUVER MEDICAL WEIGHT LOSS CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GLENN THOMAS GERHARD MD PHD (PRESIDENT)
(360) 571-7177
Entity
Organization
Contact information
Practice address
10000 NE 7TH AVE, SUITE 110, VANCOUVER, WA 98685-4599
(360) 571-7177
(360) 843-4085
Mailing address
10000 NE 7TH AVE, SUITE 110, VANCOUVER, WA 98685-4599
(360) 571-7177
(360) 843-4085
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
MD00035811
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1113943
—
WA
Enumeration date
04/14/2008
Last updated
04/14/2008
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