Individual
ELIZABETH A THORSTENSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
14406 NE 20TH AVE, VANCOUVER, WA 98686
(360) 571-4720
Mailing address
14408 NE 20TH AVE, VANCOUVER, WA 98686
(360) 571-4720
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
1784-023
WI
363A00000X
Physician Assistant
Primary
PA 60018256
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2006897
PHYSICIANS PLUS
WI
05
—
42866100
—
WI
01
—
60408
DEAN HEALTH INSURANCE
WI
Enumeration date
05/03/2006
Last updated
12/28/2021
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