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Individual

ALEXANDRA CHUDY ORNHOLT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
700 NE 87TH AVE, VANCOUVER, WA 98664
(360) 882-2778
(360) 604-1771
Mailing address
700 NE 87TH AVE, VANCOUVER, WA 98664-4896
(360) 882-2778
(360) 604-1771

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA60771579
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
500705662
OR
Enumeration date
10/21/2014
Last updated
08/06/2018
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