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LOWER COLUMBIA HEAD & NECK ASSOCIATES PC

Physicians Oral & Maxillofacial Surgery

Provider NPI: 1215150313

Organization Information:
Organization Name:  LOWER COLUMBIA HEAD & NECK ASSOCIATES PC
Authorized Official:  ALEXANDER P IEROKOMOS  PRESIDENT  360-423-0960

Practice Location:
820 11TH AVE  LONGVIEW, WA 98632-2072 US
Tel: 360-423-0960  Fax: 360-423-8902

Business Mailing Address:
820 11TH AVE  LONGVIEW, WA 98632-2072 US
Tel: 360-423-0960  Fax: 360-423-8902

NPI Information:
NPI: 1215150313
Entity Type: Organization

Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
X204E00000XPhysicians
Oral & Maxillofacial Surgery
WAMD00022010
X207Y00000XPhysicians
Otolaryngology
WAMD00022010
X207YP0228XPhysicians
Otolaryngology
WAMD00022010
X207YS0012XPhysicians
Otolaryngology
WAMD00022010
X207YX0007XPhysicians
Otolaryngology
WAMD00022010
X207YX0602XPhysicians
Otolaryngology
WAMD00022010
X207YX0905XPhysicians
Otolaryngology
WAMD00022010

Other Provider Identifiers:

IssuerNumberStateType
L&I60170WA01
7032030WA05




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