Individual
SAMANTHA JOSEFINE MOANA BRODEHL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1601 E FOURTH PLAIN BLVD, VANCOUVER, WA 98661-3753
(360) 696-4061
Mailing address
217 NE 68TH ST, VANCOUVER, WA 98665-8623
(360) 823-3562
Taxonomy
Speciality
Code
Description
License number
State
2865M2000X
Military General Acute Care Hospital
Primary
—
—
Other
Enumeration date
06/20/2014
Last updated
06/20/2014
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