Individual
DR. MARK MENDEZ VIGO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
143 GARDEN HOMES DR, COLVILLE, WA 99114-9229
(509) 684-3701
(509) 684-5817
Mailing address
PO BOX 421, LIBERTY LAKE, WA 99019-0421
(866) 747-2455
(509) 944-9644
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
MD00023934
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
50510
L&I
—
05
—
8105017
—
WA
01
—
8924175
L&I CRIME VICTIMS
—
Enumeration date
10/13/2005
Last updated
10/28/2014
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