Dermatology Associates Of Southwest Washington, PLLC
Clinic/Center, Medical Specialty in Vancouver, WA. Organization (NPI-2).
NPI number1992938906
StatusActive
Last updated in NPPESMay 31, 2012
Details
- NPI
- 1992938906
- Entity type
- Organization (NPI-2)
- Legal business name
- Dermatology Associates Of Southwest Washington, PLLC
- Organization subpart
- No
- Enumeration date
- Aug 25, 2009
- Last updated
- May 31, 2012
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261QM2500X | Clinic/Center, Medical Specialty | – | – | Yes |
Practice location
8614 E Mill Plain BlvdSuite 400
Vancouver, WA 98664-2059
Phone 360-254-5267 · Fax 360-254-6089
Mailing address
8614 E Mill Plain BlvdSuite 400
Vancouver, WA 98664-2059
Phone 360-254-5267 · Fax 360-254-6089
Authorized official
Joel H Datloff
Owner
3602545267
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