Individual
MICHAEL WALTER HIBBS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
203 SE PARK PLAZA DR, VANCOUVER, WA 98684-5886
(360) 449-7002
Mailing address
203 SE PARK PLAZA DR, SUITE 140, VANCOUVER, WA 98684-5886
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
PA00312
OR
363AS0400X
Surgical Physician Assistant
Primary
PA10004184
WA
Other
Enumeration date
08/28/2006
Last updated
07/08/2007
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