Organization
SALMON CREEK PLASTIC SURGERY PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RICHARD KENNETH GREEN JR. M.D. (PHYSICIAN AND OWNER)
(360) 574-7622
Entity
Organization
Contact information
Practice address
13712 NE 10TH AVE, VANCOUVER, WA 98685-2628
(360) 823-0860
(360) 828-1407
Mailing address
13712 NE 10TH AVE, VANCOUVER, WA 98685-2628
(360) 823-0860
(360) 828-1407
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary
—
—
2086S0122X
Plastic and Reconstructive Surgery Physician
—
—
Other
Enumeration date
12/20/2006
Last updated
12/29/2022
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