Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207VX0201X | Gynecologic Oncologist | 743 | WI |
N | 207VX0201X | Gynecologic Oncologist | MD00040252 | WA |
Y | 207VX0201X | Gynecologic Oncologist | MD204288 | OR |
NPI | 1417042854 |
---|---|
Provider Name | Kathryn F Mcgonigle |
First Address | Portland, OR 97210-3025 |
Second Address | Portland, OR 97210-3025 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/10/2006 |
Last Update Date | 08/11/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
160053987 | RAILROAD MEDICARE (01) | WA |
US2608092 | AETNA SPECIALIST NUMBER (01) | WA |