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Individual

KENDRA M LATIMER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CCSH RPSGT

Contact information

Practice address
12607 SE MILL PLAIN BLVD, VANCOUVER, WA 98684
(360) 449-1749
Mailing address
12607 SE MILLE PLAIN BLVD, VANCOUVER, WA 98684-6055
(360) 449-1749

Taxonomy

Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
863
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
863
WA
Enumeration date
02/21/2020
Last updated
02/21/2020
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