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General NPI Number Information
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NPI Number | 1881718443
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Entity Type | Organization
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Legal Business Name | PORTLAND VA MEDICAL CENTER
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Dates
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Enumeration Date | 03/19/2007
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Last Update Date | 08/14/2008
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Provider Practice Location Address
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Address Line | 7800 NE 86TH AVE
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City | VANCOUVER
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State | WA
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Zip | 98662-2897
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Country | US
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Telephone | 360-891-2719
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Fax |
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Provider Business Mailing Address
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Address Line | 7800 NE 86TH AVE
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City | VANCOUVER
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State | WA
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Zip | 98662-2897
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Country | US
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Telephone | 360-891-2719
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Fax |
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Authorized Official
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Title or Position | X-RAY TECH
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Name | MRS. DIANE EVELYN JOBIN
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Credential | AART
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Telephone | 360-690-1824
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 282N00000X
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Taxonomy Name | General Acute Care Hospital
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License Number |
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License Number State |
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