NPI 1003992090 · live from the CMS NPI Registry
Advanced Gastroenterology, PLLC
Internal Medicine, Gastroenterology in Vancouver, WA. National Provider Identifier 1003992090, active.
NPI record
| NPI | 1003992090 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Internal Medicine, Gastroenterology 207RG0100X |
| Practice location | 3250 Se 164th Ave Ste 205, Vancouver, WA 98683 |
| Practice phone | 360-946-4313 |
| Enumerated | October 31, 2006 |
| Last updated | November 7, 2024 |
| Authorized official | Samuel Sim, Partner |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Internal Medicine, Gastroenterology primary | 207RG0100X | md00042129 (WA) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.