Most Relevant Information
Provider Data
| NPI Number: | 1003507575 |
| Provider Name: | KAITLYN SUE MAYNE |
| Entity Type: | Individual |
| Taxonomy Code: | 101YM0800X |
| Specialty: | Counselor |
| License Number: |
Most Important Dates
| Enumeration Date: | 05/16/2023 |
| Last Updated: | 05/16/2023 |
Provider Practice Location
3200 NE 109TH AVE
VANCOUVER
WA
986827749
Practice Location Phone/Fax
| Phone: | 3606951014 |
| Fax: |
Provider Mailing Location
3200 NE 109TH AVE
VANCOUVER
WA
986827749
Provider Mailing Phone/Fax
| Phone: | 3606951014 |
| Fax: |