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Individual

KATIRINA GUANCIALE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
9115 SW OLESON RD, PORTLAND, OR 97223-6875
(877) 910-6538
Mailing address
14615 SW QUAIL LN APT M102, BEAVERTON, OR 97007-7668
(843) 845-7832

Taxonomy

Speciality
Code
Description
License number
State
246Z00000X
Other Specialist/Technologist
Primary

Other

Enumeration date
07/15/2020
Last updated
07/15/2020
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