Individual
MS. MANDY BOGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
2525 NE 139TH ST STE 130, VANCOUVER, WA 98686-2719
(360) 882-2778
Mailing address
PO BOX 4825, PORTLAND, OR 97208-4825
(360) 882-2778
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN60847161
WA
363LF0000X
Family Nurse Practitioner
Primary
AP61106386
WA
Other
Enumeration date
07/26/2019
Last updated
05/15/2023
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