Individual
KIP BUNN FLORY BECKWITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2821 DAGGETT AVE STE 100, KLAMATH FALLS, OR 97601-1130
(541) 274-6556
Mailing address
2730 S MOODY AVE, PORTLAND, OR 97201-5042
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
08/30/2022
Last updated
11/18/2024
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