JOHN RUSSELL PRENTICE

VANCOUVER, WA
NPI1497736110
Entity TypeIndividual
GenderMale
Sole Proprietor ?
Primary Taxonomy363A00000X Physician Assistant
(Licence: WV  PA10002522)
Enumeration Date2005-11-09
Last Update Date2007-07-08
Business Address
JOHN RUSSELL PRENTICE PA-C
11808 NE FOURTH PLAIN RD SUITE A
VANCOUVER, WA 98682-5524
Phone number: 360-253-6947
Mailing Address
JOHN RUSSELL PRENTICE PA-C
11808 NE FOURTH PLAIN RD SUITE A
VANCOUVER, WA 98682-5524
Phone number: 360-253-6947
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