Individual
MS. KIMBERLY SUSAN SHOTZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
WHCNP, LAC
Contact information
Practice address
736 SE 60TH AVE, PORTLAND, OR 97215-1906
(971) 645-4009
Mailing address
736 SE 60TH AVE, PORTLAND, OR 97215-1906
(503) 318-3352
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
AC156829
OR
363LW0102X
Women's Health Nurse Practitioner
Primary
OR 093006979N7
OR
Other
Enumeration date
09/28/2006
Last updated
05/05/2026
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