Individual
SAMREEN KHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
501 SE 172ND AVE STE 210, VANCOUVER, WA 98684-9542
(360) 882-2778
Mailing address
PO BOX 4825, PORTLAND, OR 97208-4825
(360) 882-2778
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD61200329
WA
390200000X
Student in an Organized Health Care Education/Training Program
PG193646
OR
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2201144
—
WA
Enumeration date
06/15/2016
Last updated
03/02/2023
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