Healthcare Provider Details

I. General information

NPI: 1225267800
Provider Name (Legal Business Name): RITA M ADDISON M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/05/2009
Last Update Date: 07/05/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1111 ALBERNI STREET SUITE #4201
VANCOUVER BRITISH COLUMBIA
V6E 4V2
CA

IV. Provider business mailing address

1111 ALBERNI STREET SUITE #4201
VANCOUVER BRITISH COLUMBIA
V6E 4V2
CA

V. Phone/Fax

Practice location:
  • Phone: 604-808-1545
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207ZP0102X
TaxonomyAnatomic Pathology & Clinical Pathology Physician
License Number46951
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: