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1649384165
KATHLEEN GORDON WALL
VANCOUVER, WA
NPI
1649384165
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363AM0700X Physician Assistant, Medical
(Licence: WA PA10003853)
Enumeration Date
2006-08-19
Last Update Date
2007-07-08
Business Address
Ms. KATHLEEN GORDON WALL PA-C
12607 SE MILL PLAIN BLVD
VANCOUVER, WA 98684-6055
Phone number: 360-418-6001
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Mailing Address
Ms. KATHLEEN GORDON WALL PA-C
5924 NE 25TH AVE
PORTLAND, OR 97211-6132
Phone number: 503-493-0546
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