Provider Demographics
NPI:1407929615
Name:VANVLEET, JAMES D (LMP)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:D
Last Name:VANVLEET
Suffix:
Gender:M
Credentials:LMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28831 NE 10TH ST
Mailing Address - Street 2:
Mailing Address - City:CARNATION
Mailing Address - State:WA
Mailing Address - Zip Code:98014-9619
Mailing Address - Country:US
Mailing Address - Phone:425-922-1800
Mailing Address - Fax:
Practice Address - Street 1:16150 NE 85TH ST
Practice Address - Street 2:SUITE 120
Practice Address - City:REDMOND
Practice Address - State:WA
Practice Address - Zip Code:98052-3539
Practice Address - Country:US
Practice Address - Phone:425-922-1800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00018375174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist