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NPI Code Detail

MEDICARE: SOUTHWEST WASHINGTON MEDICAL CENTER ANTICOAGULATION CLINIC

MEDICARE: SOUTHWEST WASHINGTON MEDICAL CENTER ANTICOAGULATION CLINIC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QH0100XHealth Service Clinic/Center

General Provider Information

NPI Number : 1447460514
Entity Type Code : Organization
Provider Name (Legal Business Name) : SOUTHWEST WASHINGTON MEDICAL CENTER ANTICOAGULATION CLINIC
Provider Business Mailing Address
First Line : 400 NE MOTHER JOSEPH PL
Second Line :
City : VANCOUVER
State : WA
Zip : 98664-3200
Country : US
Telephone Number : 360-696-5138
Fax Number : 360-696-5237
Provider Business Practice Location Address
First Line : 8716 E MILL PLAIN BLVD
Second Line :
City : VANCOUVER
State : WA
Zip : 98664-2531
Country : US
Telephone Number : 360-696-5138
Fax Number : 360-696-5237
Authorized Official
Title or Position : ASSISTANT DIRECTOR OF PHARMACY
Name : LONNYE FINNEMAN
Credential : PHARM.D.
Telephone Number : 360-514-2225
Provider Enumeration Date : 05/23/2007
Last Update Date : 08/22/2020

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Directions to “SOUTHWEST WASHINGTON MEDICAL CENTER ANTICOAGULATION CLINIC ” Practice Location

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