Individual
KA'IMIALAIMAKA LA VINE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PMHNP-BC
Contact information
Practice address
10700 SW BEAVERTON HILLSDALE HWY STE 560, BEAVERTON, OR 97005-4791
(503) 230-7007
Mailing address
10700 SW BEAVERTON HILLSDALE HWY STE 560, BEAVERTON, OR 97005-4791
(971) 238-4543
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
10030537
OR
Other
Enumeration date
08/30/2024
Last updated
06/30/2025
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