Healthcare Provider Details

I. General information

NPI: 1376516278
Provider Name (Legal Business Name): ANDREW H GREENHILL MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/10/2006
Last Update Date: 02/22/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2525 NE 139TH ST
VANCOUVER WA
98686-2719
US

IV. Provider business mailing address

700 NE 87TH AVE
VANCOUVER WA
98664-1913
US

V. Phone/Fax

Practice location:
  • Phone: 360-397-3980
  • Fax: 360-604-1739
Mailing address:
  • Phone: 360-397-1500
  • Fax: 360-397-3128

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License NumberMD016805E
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code207K00000X
TaxonomyAllergy & Immunology Physician
License NumberMD00047680
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: