Individual
LISA VASANTH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
700 NE 87TH AVE # 330, VANCOUVER, WA 98664-1913
(360) 882-2778
(360) 604-1730
Mailing address
PO BOX 873010, VANCOUVER, WA 98687-3010
(360) 882-2778
(360) 604-1730
Taxonomy
Speciality
Code
Description
License number
State
207RR0500X
Rheumatology Physician
222188
NY
207RR0500X
Rheumatology Physician
Primary
MD60631890
WA
Other
Enumeration date
01/18/2007
Last updated
04/13/2016
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