Individual
KENNETH FAVOUR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
700 NE 87TH AVE, VANCOUVER, WA 98664-1913
(360) 254-1240
(360) 397-3128
Mailing address
500 NE MULTNOMAH ST STE 100, PORTLAND, OR 97232-2031
(503) 813-3860
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD00039094
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8257792
—
WA
Enumeration date
05/26/2006
Last updated
02/04/2022
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