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Individual

MS. KATHLEEN ELIZABETH KING

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LAC, PTA

Contact information

Practice address
1111 SW 10TH AVE, PORTLAND, OR 97205-2411
(503) 294-7420
(503) 294-7411
Mailing address
1111 SW 10TH AVE, PORTLAND, OR 97205-2411
(503) 294-7420
(503) 294-7411

Taxonomy

Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
AC01174
OR
225200000X
Physical Therapy Assistant
7946
OR

Other

Enumeration date
01/02/2008
Last updated
09/24/2008
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