Individual
DR. BRUCE JAMES ANDISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2101 NE 139TH ST, SUITE 350, VANCOUVER, WA 98686-2309
(360) 256-4060
(360) 256-0103
Mailing address
2101 NE 139TH ST, SUITE 350, VANCOUVER, WA 98686-2309
(360) 256-4060
(360) 256-0103
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
MD00020934
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
160027437
MEDICARE RR
WA
05
—
8307027
—
WA
Enumeration date
01/20/2006
Last updated
02/18/2011
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