Individual
KIMBERLY A SMITH-CUPANI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1321 NE 99TH AVE, SUITE 200, PORTLAND, OR 97220-9436
(503) 215-4250
Mailing address
PO BOX 3158, PORTLAND, OR 97208-3158
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD17933
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
044748
—
OR
Enumeration date
07/14/2006
Last updated
10/02/2020
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