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Individual

KATHRYN WRIGHT MANIFACIER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LPN

Contact information

Practice address
69861 E SKOOKUM LN, RHODODENDRON, OR 97049-9754
(503) 622-9191
Mailing address
PO BOX 1295, WELCHES, OR 97067-1295
(503) 622-9191

Taxonomy

Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
000006551LPN
OR

Other

Enumeration date
10/16/2012
Last updated
10/16/2012
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