Individual
KIMBERLY DOLAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSS
Contact information
Practice address
1190 BROADWAY ST NE, SALEM, OR 97301-1141
(503) 393-4273
Mailing address
1018 BOEDIES DR, SILVERTON, OR 97381-1192
(971) 283-6041
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
4948956
OR
Other
Enumeration date
08/20/2025
Last updated
08/20/2025
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