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NPI Code Detail

MEDICARE: ANDREW VINCENT M.D.

MEDICARE: ANDREW VINCENT M.D.
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
1207V00000XObstetrics & Gynecology PhysicianMD00036937WA

General Provider Information

NPI Number : 1629040563
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANDREW VINCENT M.D.
Provider Business Mailing Address
First Line : PO BOX 25126
Second Line :
City : PORTLAND
State : OR
Zip : 97298-0126
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2211 NE 139TH ST
Second Line :
City : VANCOUVER
State : WA
Zip : 98686-2742
Country : US
Telephone Number : 503-812-8988
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/04/2006
Last Update Date : 07/08/2007

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