Provider Demographics
NPI:1235702796
Name:VIOS FERTILITY INSTITUTE PACIFIC NORTHWEST PC
Entity Type:Organization
Organization Name:VIOS FERTILITY INSTITUTE PACIFIC NORTHWEST PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIR INS CRED & PAYOR CONTTRACTS
Authorized Official - Prefix:
Authorized Official - First Name:KATRINA
Authorized Official - Middle Name:
Authorized Official - Last Name:MARSHALL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:773-435-9036
Mailing Address - Street 1:2501 NE 134TH ST STE 100
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98686-3027
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2501 NE 134TH ST STE 100
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98686-3027
Practice Address - Country:US
Practice Address - Phone:360-535-7590
Practice Address - Fax:773-437-6811
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-22
Last Update Date:2024-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VE0102XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyReproductive EndocrinologyGroup - Single Specialty