Individual
DR. LYLE WILFRED NELSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.,D.M.D.
Contact information
Practice address
3215 SE 192ND AVE, SUITE 112, VANCOUVER, WA 98683-1469
(360) 256-7100
(360) 256-8886
Mailing address
3215 SE 192ND AVE, SUITE 112, VANCOUVER, WA 98683-1469
(360) 256-7100
(360) 256-8886
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
DE00007605
WA
Other
Enumeration date
04/09/2007
Last updated
07/08/2007
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