Individual
KANSYS CLOUSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1639 SE ENSIGN LN # B103, WARRENTON, OR 97146-7308
(503) 338-4500
Mailing address
2549 QUEEN ST # 2, SEASIDE, OR 97138-7370
(406) 396-7083
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
201808580NP-PP
OR
Other
Enumeration date
06/18/2018
Last updated
03/04/2019
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