Individual
KEVIN OLDS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CRM
Contact information
Practice address
3459 SE PEPPERWOOD WAY, HILLSBORO, OR 97123-8664
(503) 998-6040
Mailing address
PO BOX 4266, HILLSBORO, OR 97123-1957
(503) 998-6040
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
110343
OR
Other
Enumeration date
11/07/2023
Last updated
01/23/2024
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