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Individual

DR. KRISTIN BROOKE LEGRAND

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DO

Contact information

Practice address
3101 SE 192ND AVE, STE 106, VANCOUVER, WA 98683-1443
(360) 553-7400
Mailing address
PO BOX 3158, PORTLAND, OR 97208-3158
(503) 215-6494

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
OP60196401
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1760643886
WA
05
500639748
OR
Enumeration date
06/20/2008
Last updated
07/02/2021
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