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1497736110
JOHN RUSSELL PRENTICE
VANCOUVER, WA
NPI
1497736110
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363A00000X Physician Assistant
(Licence: WV PA10002522)
Enumeration Date
2005-11-09
Last Update Date
2007-07-08
Business Address
-- JOHN RUSSELL PRENTICE PA-C
11808 NE FOURTH PLAIN RD SUITE A
VANCOUVER, WA 98682-5524
Phone number: 360-253-6947
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Mailing Address
-- JOHN RUSSELL PRENTICE PA-C
11808 NE FOURTH PLAIN RD SUITE A
VANCOUVER, WA 98682-5524
Phone number: 360-253-6947
Copy
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