Individual
KARI WATTENBARGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1000 SE UGLOW AVE, DALLAS, OR 97338-2645
(503) 623-8376
Mailing address
1000 SE UGLOW AVE, DALLAS, OR 97338-2645
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA01386
OR
Other
Enumeration date
09/16/2008
Last updated
03/11/2009
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