Most Relevant Information
Provider Data
| NPI Number: | 1003583469 |
| Provider Name: | IMOGEN KANE |
| Entity Type: | Individual |
| Taxonomy Code: | 390200000X |
| Specialty: | Student in an Organized Health Care Education/Training Program |
| License Number: |
Most Important Dates
| Enumeration Date: | 08/24/2021 |
| Last Updated: | 08/24/2021 |
Provider Practice Location
12607 SE MILL PLAIN BLVD
VANCOUVER
WA
986846055
Practice Location Phone/Fax
| Phone: | 3604186001 |
| Fax: |
Provider Mailing Location
1234 NW 25TH AVE
PORTLAND
OR
972102423
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |