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Individual

MRS. EVONNE MARIA KANDAS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
N.P.

Contact information

Practice address
1130 NW 22ND AVE, SUITE 110, PORTLAND, OR 97210-2900
(503) 413-8654
(503) 413-8655
Mailing address
1130 NW 22ND AVE, SUITE 110, PORTLAND, OR 97210-2900
(503) 413-8654
(503) 413-8655

Taxonomy

Speciality
Code
Description
License number
State
363LW0102X
Women's Health Nurse Practitioner
Primary
089000443N7
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2006647
WA
05
268963
OR
Enumeration date
05/24/2005
Last updated
04/21/2017
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