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General NPI Number Information
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NPI Number | 1679582217
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Entity Type | Organization
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Legal Business Name | SALMON CREEK FAMILY PRACTICE
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Dates
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Enumeration Date | 08/05/2006
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Last Update Date | 10/06/2008
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Provider Practice Location Address
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Address Line | 1319 NE 134TH ST STE 107
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City | VANCOUVER
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State | WA
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Zip | 98685-2718
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Country | US
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Telephone | 360-566-4700
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Fax | 360-566-4739
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Provider Business Mailing Address
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Address Line | 1319 NE 134TH ST STE 107
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City | VANCOUVER
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State | WA
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Zip | 98685-2717
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Country | US
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Telephone | 360-566-6726
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Fax | 360-566-4739
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Authorized Official
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Title or Position | OFFICE ADMINISTRATOR
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Name | FELMA S PANGANIBAN
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Credential |
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Telephone | 360-566-4700
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State |
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