# KIMBERLY ANN PRIVITERA, PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1184835274
- **Authorized official:** DR. KIMBERLY PRIVITERA DC (PRESIDENT)
- **Authorized official phone:** (503) 774-1776

## Contact information

- **Practice address:** 8029 SE WOODSTOCK BLVD, PORTLAND, OR 97206-5885
- **Practice address phone:** (503) 774-1776
- **Mailing address:** 8029 SE WOODSTOCK BLVD, PORTLAND, OR 97206-5885
- **Mailing address phone:** (503) 774-1776

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 111NX0100X | Occupational Health Chiropractor | 273094 | OR | Yes |

## Other

- **Enumeration date:** 05/24/2007
- **Last updated:** 08/22/2020