Individual
MS. KACIE MARIE HAMREUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
315 SE STONEMILL DR STE 103, VANCOUVER, WA 98684-6998
(360) 666-4480
Mailing address
PO BOX 3158, PORTLAND, OR 97208-3158
(503) 215-6494
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA60675885
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500715960
—
OR
Enumeration date
06/09/2015
Last updated
04/20/2022
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