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Individual

KAITLYN MARY MCGOWAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
AGPCNP-BC

Contact information

Practice address
1000 N PROVIDENCE DR STE 120, NEWBERG, OR 97132-7582
(503) 537-5900
Mailing address
PO BOX 3158, PORTLAND, OR 97208-3158
(503) 215-6494

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
202008069NP-PP
OR
363L00000X
Nurse Practitioner
95013322
CA
363LG0600X
Gerontology Nurse Practitioner
Primary
202008069NP-PP
OR

Other

Enumeration date
11/25/2019
Last updated
10/27/2023
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