Individual ProviderVivian ChanPhysician AssistantPhysician Assistants & Advanced Practice Nursing ProvidersPractice Address505 NE 87th Ave Ste 250, Vancouver, WA 98664-1965(360) 514-1010PECOS EnrollmentBased on the most recent information from CMS, provider Vivian Chan is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.Part BMedicare Part BEnrolledHHAHome Health AgencyEnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceEnrolledCMS last updated its PECOS records yesterday at 12:57 PM.Profile DetailsProvider ID1760042006Provider TypeIndividualFull NameChan, VivianTitleMs.GenderFemaleSole ProprietorNoEnumeration Date6/18/2019Last Updated4/27/2021Contact InformationPractice LocationPractice Address505 NE 87th Ave Ste 250, Vancouver, WA 98664-1965Phone(360) 514-1010FaxUnlisted FaxMailing LocationMailing Address505 NE 87th Ave Ste 250, Vancouver, WA 98664-1965PhoneUnlisted PhoneFaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode363AS0400XPrimaryDescriptionPhysician AssistantPhysician Assistants & Advanced Practice Nursing ProvidersLicense61153994WashingtonCode390200000XDescriptionStudent in an Organized Health Care Education/Training ProgramStudent, Health CareLicenseUnlisted Issuer