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Individual

MR. GARY A ROSE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
1603 E 4TH PLAIN BLVD (V3VI), VA MEDICAL CENTER, VANCOUVER, WA 98661
(360) 696-4061
(360) 905-1738
Mailing address
2506 NE 80TH ST, VANCOUVER, WA 98665-1139
(360) 546-5252
(360) 905-1738

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary

Other

Enumeration date
10/16/2006
Last updated
07/08/2007
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