Stephanie Vasquez

 
 Stephanie Vasquez 
 MRN: 5612613 
 Preferred Pharmacy (continued) 
 Referral (continued) 
 Order 
 MRI ARTH SHOULDER W/ CONTRAST RIGHT [676335615] 
 Electronically Signed by: Dennis S Frerichs, PA-C on 2023-09-23 0619 
 Status: Completed 
 This order may be acted on in another encounter. 
 Ordering user: Dennis S Frerichs, PA-C 02/22/23 0949 
 Authorized by: Dennis S Frerichs, PA-C 
 Ordered during: Office Visit on 2021-01-18
 Screening Form 
 General Information 
 Patient: Stephanie Vasquez
 MRN: 5612613 
 birthdate: 1994-09-30
 Mobile: 561-961-4619 
 Sex Assigned at Birth: Male 
 MC ROCKWOOD MAIN CLINIC Stephanie Vasquez
 - SPOKANE 
 MRN: 5602313, birthdate: 1994-09-30, Sex: M 
 400 East 5th Ave 
 visit: 2018-01-08
 Spokane WA 99202-1334 
 Page 89 
 Printed by 414221 at 7/17/23 9:40 AM