Individual
KATHRYN F MCGONIGLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1015 NW 22ND AVE, PORTLAND, OR 97210-3025
(503) 413-8654
(503) 413-8655
Mailing address
1015 NW 22ND AVE, PORTLAND, OR 97210-3025
(503) 413-8654
(503) 413-8655
Taxonomy
Speciality
Code
Description
License number
State
207VX0201X
Gynecologic Oncology Physician
743
WI
207VX0201X
Gynecologic Oncology Physician
MD00040252
WA
207VX0201X
Gynecologic Oncology Physician
Primary
MD204288
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
160053987
RAILROAD MEDICARE
WA
01
—
US2608092
AETNA SPECIALIST NUMBER
WA
Enumeration date
10/03/2006
Last updated
11/08/2021
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