Individual
VU LE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1420 AHTANUM RIDGE DR, UNION GAP, WA 98903-1839
(509) 454-7700
Mailing address
PO BOX 719, SUNNYSIDE, WA 98944-0719
(509) 837-1617
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
MD60246817
WA
207RG0100X
Gastroenterology Physician
Primary
MD60246817
WA
Other
Enumeration date
02/07/2007
Last updated
04/07/2023
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