Individual
EDWARD LEE VANESSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
7905 NE 124TH AVE, VANCOUVER, WA 98682-4023
(360) 609-6664
Mailing address
7905 NE 124TH AVE, VANCOUVER, WA 98682-4023
(360) 609-6664
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
04/30/2021
Last updated
04/30/2021
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