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General NPI Number Information
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NPI Number | 1326756180
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Entity Type | Organization
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Legal Business Name | COLUMBIA FOOT AND ANKLE CLINIC-VIRGIL GENE LIVINSTON
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Dates
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Enumeration Date | 11/10/2022
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Last Update Date | 12/07/2023
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Provider Practice Location Address
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Address Line | 12411 NE 70TH CIR STE 106
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City | VANCOUVER
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State | WA
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Zip | 98682-4885
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Country | US
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Telephone | 602-615-9915
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Fax |
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Provider Business Mailing Address
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Address Line | 12411 NE 70TH CIR STE 106
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City | VANCOUVER
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State | WA
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Zip | 98682-4885
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Country | US
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Telephone | 602-615-9915
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Fax |
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Authorized Official
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Title or Position | PHYSICIAN-PODIATRIST
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Name | DR. VIRGIL GENE LIVINGSTON
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Credential | MD-DPM
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Telephone | 602-615-9915
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 213EP1101X
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Taxonomy Name | Primary Podiatric Medicine Podiatrist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number |
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License Number State |
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