Provider Demographics
NPI:1154414878
Name:PEASE, VANCE (CTRS)
Entity type:Individual
Prefix:MR
First Name:VANCE
Middle Name:
Last Name:PEASE
Suffix:
Gender:M
Credentials:CTRS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1660 S COLUMBIAN WAY
Mailing Address - Street 2:SCI-128
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98108
Mailing Address - Country:US
Mailing Address - Phone:206-277-1648
Mailing Address - Fax:206-764-2799
Practice Address - Street 1:1660 S COLUMBIAN WAY
Practice Address - Street 2:SCI-128
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98108
Practice Address - Country:US
Practice Address - Phone:206-277-1648
Practice Address - Fax:206-764-2799
Is Sole Proprietor?:No
Enumeration Date:2006-10-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225800000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRecreation Therapist