Provider Demographics
NPI:1861498404
Name:VEJVODA, HANK J (MD)
Entity Type:Individual
Prefix:DR
First Name:HANK
Middle Name:J
Last Name:VEJVODA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:820 N CHELAN AVE
Mailing Address - Street 2:
Mailing Address - City:WENATCHEE
Mailing Address - State:WA
Mailing Address - Zip Code:98801-2028
Mailing Address - Country:US
Mailing Address - Phone:509-663-8711
Mailing Address - Fax:
Practice Address - Street 1:520 N CHELAN AVE
Practice Address - Street 2:
Practice Address - City:WENATCHEE
Practice Address - State:WA
Practice Address - Zip Code:98801-6697
Practice Address - Country:US
Practice Address - Phone:509-662-2211
Practice Address - Fax:509-662-8756
Is Sole Proprietor?:No
Enumeration Date:2005-06-27
Last Update Date:2015-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00041838207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA324563OtherWVH LNI
WA1861498404Medicaid
WAP01280902OtherRR MEDICARE WVH
WAP01280902OtherRR MEDICARE WVH