Provider Demographics
NPI:1720422512
Name:OPTIONS360 WOMEN'S CLINIC
Entity Type:Organization
Organization Name:OPTIONS360 WOMEN'S CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:PAMELLA
Authorized Official - Middle Name:J
Authorized Official - Last Name:MARCHAND
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:360-369-4576
Mailing Address - Street 1:PO BOX 61545
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98666-1545
Mailing Address - Country:US
Mailing Address - Phone:503-816-1882
Mailing Address - Fax:360-567-0285
Practice Address - Street 1:221 NE 104TH AVE STE 209
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98664-4505
Practice Address - Country:US
Practice Address - Phone:360-567-0285
Practice Address - Fax:360-567-2232
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-23
Last Update Date:2020-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VX0000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyObstetricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA2029258Medicaid