Individual
ANNE KIMBERLY
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
3203 SE WOODSTOCK BLVD, PORTLAND, OR 97202-8138
(503) 777-7281
(503) 777-7209
Mailing address
3181SWSAM JACKSON PARK RD, PORTLAND, OR 97239-3011
(503) 494-7551
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
092000112RN
OR
363L00000X
Nurse Practitioner
092000112N1
OR
Other
Enumeration date
07/28/2005
Last updated
07/06/2015
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