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Individual

MR. RICHARD ALLEN ENDERS JR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PAC

Contact information

Practice address
9430 NE VANCOUVER MALL DR, VANCOUVER, WA 98662-6172
(360) 253-6947
(360) 448-6324
Mailing address
14611 NE 165TH AVE, BRUSH PRAIRIE, WA 98606-9610
(360) 256-7344
(360) 256-7344

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA10000092
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
91-1878809
TAX ID
WA
Enumeration date
05/03/2007
Last updated
10/31/2013
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