Individual
KATHLEEN KLUNK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APN
Contact information
Practice address
1400 NE ALBERTA ST, PORTLAND, OR 97211-5044
(844) 966-6777
Mailing address
1261 NW OVERTON ST APT 510, PORTLAND, OR 97209-3896
(708) 334-1842
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
041382963
IL
363LF0000X
Family Nurse Practitioner
Primary
201609389NP-PP
OR
Other
Enumeration date
01/05/2016
Last updated
11/20/2018
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