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Organization

AETHENA GYNECOLOGY ASSOCIATES, P.S.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
LESLIE A STRUXNESS M.D. (PHYSICIAN/OWNER)
(360) 693-7878
Entity
Organization

Contact information

Practice address
1498 SE TECH CENTER PLACE, SUITE 100, VANCOUVER, WA 98683
(360) 693-7878
(360) 892-5724
Mailing address
1498 SE TECH CENTER PLACE, SUITE 100, VANCOUVER, WA 98683
(360) 693-7878
(360) 892-5724

Taxonomy

Speciality
Code
Description
License number
State
207VG0400X
Gynecology Physician
Primary
363LW0102X
Women's Health Nurse Practitioner
AP30003214
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
7124332
WA
Enumeration date
05/08/2007
Last updated
09/29/2011
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