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General NPI Number Information
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NPI Number | 1790237212
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Entity Type | Organization
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Legal Business Name | THE VANCOUVER CLINIC, INC. PS
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Dates
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Enumeration Date | 11/01/2016
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Last Update Date | 11/01/2016
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Provider Practice Location Address
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Address Line | 2525 NE 139TH ST # 280
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City | VANCOUVER
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State | WA
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Zip | 98686-2719
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Country | US
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Telephone | 360-882-2778
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Fax | 360-604-1780
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Provider Business Mailing Address
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Address Line | PO BOX 873010
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City | VANCOUVER
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State | WA
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Zip | 98687-3010
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Country | US
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Telephone | 360-882-2778
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Fax |
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Authorized Official
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Title or Position | CHIEF MEDICAL OFFICER
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Name | DR. ALFRED SEEKAMP
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Credential | MD
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Telephone | 360-397-5532
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332H00000X
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Taxonomy Name | Eyewear Supplier
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License Number |
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License Number State |
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