Individual
MIRIAM M KIRSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2450 SW PERKINS AVE, PENDLETON, OR 97801-4302
(541) 966-6638
(541) 278-8324
Mailing address
2450 SW PERKINS AVE, PENDLETON, OR 97801-4302
(541) 966-6638
(541) 278-8324
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA195713
OR
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/04/2018
Last updated
10/13/2021
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