Individual
KIEREN ANNE MARR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3181 SW SAM JACKSON PARK RD, L457, PORTLAND, OR 97239-3011
(503) 418-1685
(503) 494-4264
Mailing address
3181 SW SAM JACKSON PARK RD, L457, PORTLAND, OR 97239-3011
Taxonomy
Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
Primary
MD00034037
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4826
INTERNAL ID-MOTOR VEHICLE ID
—
05
—
8225351
—
WA
Enumeration date
10/13/2006
Last updated
07/11/2007
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