Individual
IMOGEN KANE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
12607 SE MILL PLAIN BLVD, VANCOUVER, WA 98684-6055
(360) 418-6001
Mailing address
1234 NW 25TH AVE, PORTLAND, OR 97210-2423
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
08/24/2021
Last updated
08/24/2021
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