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AETHENA GYNECOLOGY ASSOCIATES P.S. NPI 1710190103


NPI Information

NPI: 1710190103
Provider Name: AETHENA GYNECOLOGY ASSOCIATES, P.S.
Classification: Obstetrics & Gynecology - 207VG0400X
Entity Type: Organization

Specialization: Gynecology

Address:
1498 SE TECH CENTER PLACE
SUITE 100
VANCOUVER, WA
ZIP 98683
Phone: (360) 693-7878
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AETHENA GYNECOLOGY ASSOCIATES, P.S. is a gynecology obstetrics gynecology in Vancouver, WA. The provider is a physician who specializes in diagnosis, treatment, and management of patients with gynecologic conditions. Source: National Uniform Claim Committee AETHENA GYNECOLOGY ASSOCIATES, P.S. NPI is 1710190103. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

1498 SE TECH CENTER PLACE
SUITE 100
VANCOUVER, WA
ZIP 98683
Phone: (360) 693-7878
Fax: (360) 892-5724

The provider's authorized official is Leslie A Struxness .
The authorized official title is Physician/owner and has the following contact phone number (360) 693-7878.

The enumeration date for this NPI number is 5/8/2007 and was last updated on 9/29/2011.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1363LW0102XNurse PractitionerWomen's HealthAP30003214WASHINGTONNo
2207VG0400XObstetrics & GynecologyGynecologyYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
17124332MEDICAIDWASHINGTON
28850631MEDICARE ID-TYPE UNSPECIFIEDWASHINGTON

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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