Individual
MARY KATHLEEN MAGNUSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
1915 E REZANOF DR, KODIAK, AK 99615
(907) 486-9500
Mailing address
PO BOX 3706, PORTLAND, OR 97208-3706
(866) 907-1068
(425) 917-9141
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
NURA325
AK
Other
Enumeration date
01/29/2007
Last updated
05/03/2021
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