Provider Demographics
NPI:1841039443
Name:PACIFIC GASTRO HEALTH PLLC
Entity type:Organization
Organization Name:PACIFIC GASTRO HEALTH PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MEHDI
Authorized Official - Middle Name:S
Authorized Official - Last Name:FERDOWS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:360-823-0880
Mailing Address - Street 1:8506 E MILL PLAIN BLVD STE C
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98664-2021
Mailing Address - Country:US
Mailing Address - Phone:360-823-0880
Mailing Address - Fax:360-823-0883
Practice Address - Street 1:8506 E MILL PLAIN BLVD STE C
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98664-2021
Practice Address - Country:US
Practice Address - Phone:360-823-0880
Practice Address - Fax:360-823-0883
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PACIFIC GASTROENTEROLOGY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-05-22
Last Update Date:2025-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical