Individual
MRS. KAYLENE HANSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CO61536110
Contact information
Practice address
165 E HAWTHORNE AVE, COLVILLE, WA 99114-2629
(509) 684-4597
Mailing address
165 E HAWTHORNE AVE, COLVILLE, WA 99114-2629
(509) 684-4597
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
CO61536110
WA
Other
Enumeration date
04/04/2024
Last updated
01/07/2025
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