Provider Demographics
NPI:1215566542
Name:BISHOP, VANESSA E (NIC, CORECHI, OCHI)
Entity Type:Individual
Prefix:
First Name:VANESSA
Middle Name:E
Last Name:BISHOP
Suffix:
Gender:F
Credentials:NIC, CORECHI, OCHI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1700 NE MARKET DR UNIT 1659
Mailing Address - Street 2:
Mailing Address - City:FAIRVIEW
Mailing Address - State:OR
Mailing Address - Zip Code:97024-1827
Mailing Address - Country:US
Mailing Address - Phone:503-629-6938
Mailing Address - Fax:
Practice Address - Street 1:3401 E 18TH ST
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98661-5209
Practice Address - Country:US
Practice Address - Phone:503-629-6938
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-04-07
Last Update Date:2020-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171R00000XOther Service ProvidersInterpreter