Most Relevant Information
Provider Data
| NPI Number: | 1003050071 |
| Provider Name: | BREANNE CANNON PA-C |
| Entity Type: | Individual |
| Taxonomy Code: | 363AS0400X |
| Specialty: | Physician Assistant |
| License Number: | PA 60234603 |
Most Important Dates
| Enumeration Date: | 04/22/2009 |
| Last Updated: | 04/13/2021 |
Provider Practice Location
200 NE MOTHER JOSEPH PL STE 300
VANCOUVER
WA
98664
Practice Location Phone/Fax
| Phone: | 3602546161 |
| Fax: | 3604491146 |
Provider Mailing Location
200 NE MOTHER JOSEPH PL STE 210
VANCOUVER
WA
986643295
Provider Mailing Phone/Fax
| Phone: | 3602546161 |
| Fax: | 3604491146 |