Healthcare Provider Details

I. General information

NPI: 1194592808
Provider Name (Legal Business Name): AUBREY ANN TOMKINSON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/04/2023
Last Update Date: 12/04/2023
Certification Date: 12/04/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6221 NE FOURTH PLAIN BLVD
VANCOUVER WA
98661-7206
US

IV. Provider business mailing address

6221 NE FOURTH PLAIN BLVD
VANCOUVER WA
98661-7206
US

V. Phone/Fax

Practice location:
  • Phone: 360-831-0908
  • Fax: 360-952-8641
Mailing address:
  • Phone: 360-831-0908
  • Fax: 360-952-8641

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: