Individual
KATHLEEN MARIE HANSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.M.D.
Contact information
Practice address
1601 E FOURTH PLAIN BLVD, V3 DENT, VANCOUVER, WA 98661-3713
(360) 619-5990
Mailing address
3710 SW US VETERANS HOSPITAL RD, P3 DENT, PORTLAND, OR 97239-2964
(503) 220-8262
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D9873
OR
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
10/02/2012
Last updated
09/16/2016
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