Individual
MS. KIMBERLY JAN SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.T.
Contact information
Practice address
909 NE BRAZEE ST, #1, PORTLAND, OR 97212-4162
(503) 280-1107
Mailing address
909 NE BRAZEE ST, #1, PORTLAND, OR 97212-4162
(503) 280-1107
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
3309
OR
Other
Enumeration date
05/28/2013
Last updated
05/28/2013
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