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General NPI Number Information
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NPI Number | 1639618630
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Entity Type | Organization
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Legal Business Name | DIGESTIVE GI CARE
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Dates
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Enumeration Date | 02/23/2017
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Last Update Date | 02/23/2017
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Provider Practice Location Address
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Address Line | 305 SW CHKALOV DR 111-140
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City | VANCOUVER
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State | WA
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Zip | 98683
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Country | US
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Telephone | 360-601-7393
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Fax |
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Provider Business Mailing Address
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Address Line | 305 SW CHKALOV DR 111-140
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City | VANCOUVER
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State | WA
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Zip | 98683
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Country | US
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Telephone | 360-601-7393
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | SON T DO
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Credential | MD
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Telephone | 360-601-7393
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number |
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License Number State |
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