Organization
THE WOMENS CLINIC OF VANCOUVER PS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KATHY C VIRTUE (MANAGER)
(360) 256-4060
Entity
Organization
Contact information
Practice address
2101 NE 139TH ST, SUITE 350, VANCOUVER, WA 98686-2309
(360) 256-4060
(360) 256-0103
Mailing address
2101 NE 139TH ST, SUITE 350, VANCOUVER, WA 98686-2309
(360) 256-4060
(360) 256-0103
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
50D1050187
CUA ID
WA
05
—
7827702
—
WA
01
—
CP7561
MEDICARE RR
WA
Enumeration date
12/13/2006
Last updated
04/02/2018
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