Individual
ANNA PENGRA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MAT, LAT
Contact information
Practice address
10402 NE 88TH ST, VANCOUVER, WA 98662-2178
(806) 518-2014
Mailing address
10402 NE 88TH ST, VANCOUVER, WA 98662-2178
(806) 518-2014
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT5651
TX
Other
Enumeration date
05/20/2016
Last updated
05/20/2016
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