Individual
CARY LO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1601 E 4TH PLAIN BLVD, VANCOUVER, WA 98661-3713
(360) 397-8246
Mailing address
2005 N WILLIAMS AVE APT 507, PORTLAND, OR 97227-2056
(415) 624-9304
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
CG61345490
WA
Other
Enumeration date
09/05/2022
Last updated
09/05/2022
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