Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RX0202X | Medical Oncology | MD00029452 | WA |
NPI | 1043437098 |
---|---|
Provider Name | Dr. Stephen Chandler |
First Address | Vancouver, WA 98683-8004 |
Second Address | Vancouver, WA 98664-1965 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/04/2007 |
Last Update Date | 04/02/2022 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2000464 | (05) | WA |