Individual
JOSEPH PROVINCE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
200 NE MOTHER JOSEPH PL STE 210, VANCOUVER, WA 98664-3295
(360) 254-6161
(360) 449-1146
Mailing address
200 NE MOTHER JOSEPH PL STE 210, VANCOUVER, WA 98664-3295
(360) 254-6161
(360) 449-1146
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
PA182241
OR
363AS0400X
Surgical Physician Assistant
Primary
PA61208141
WA
363AS0400X
Surgical Physician Assistant
PA9107470
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010158600
—
FL
Enumeration date
09/25/2013
Last updated
10/28/2021
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