Individual
CELIA KATHERINE DERVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
700 NE 87TH AVE, VANCOUVER, WA 98664-1913
(360) 882-2778
(360) 604-1753
Mailing address
700 NE 87TH AVE, VANCOUVER, WA 98664-1913
(360) 882-2778
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
MD60076609
WA
207UN0901X
Nuclear Cardiology Physician
MD60076609
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8547234
—
WA
Enumeration date
12/18/2008
Last updated
09/28/2015
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