Organization
VANCOUVER ENT AND ENT OF THE NORTHWEST PLLC
Active
Other names
Vancouver Ear, Nose & Throat Head & Neck Surgery Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. STEPHANIE HANKS (PRACTICE MANAGER)
(360) 256-4425
Entity
Organization
Contact information
Practice address
1405 SE 164TH AVE, SUITE 102, VANCOUVER, WA 98683-9644
(360) 256-4425
(360) 256-2474
Mailing address
1405 SE 164TH AVE, SUITE 102, VANCOUVER, WA 98683-9644
(360) 256-4425
(360) 254-1844
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
602 593 569
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7135486
—
WA
01
—
DF7194
RAILROAD MEDICARE GROUP
WA
Enumeration date
11/13/2006
Last updated
05/28/2015
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