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General NPI Number Information
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NPI Number | 1891154530
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Entity Type | Individual
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Provider Name | THOMAS CARL VANHOOSE MD
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Gender | Male
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Dates
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Enumeration Date | 02/22/2016
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Last Update Date | 06/30/2025
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Provider Practice Location Address
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Address Line | 2525 NE 139TH ST STE 110
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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 |
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Provider Business Mailing Address
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Address Line | 2525 NE 139TH ST STE 110
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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 |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RA0000X
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Taxonomy Name | Adolescent Medicine (Internal Medicine) Physician
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License Number | 54784
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License Number State | KY
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Taxonomy #2
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | MD.MD.61691088
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License Number State | WA
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Taxonomy #3
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | MD.MD.61691088
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License Number State | WA
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