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Individual

JANE KIMHOFFMAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
15220 NW LAIDLAW RD, SUITE 100, PORTLAND, OR 97229-7716
(503) 418-2000
(503) 418-2400
Mailing address
15220 NW LAIDLAW RD, SUITE 100, PORTLAND, OR 97229-7716
(503) 418-2000
(503) 418-2400

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
2000220
NM
208000000X
Pediatrics Physician
Primary
MD154899
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
500637176
OR
01
R160676
MEDICARE PTAN
Enumeration date
10/03/2006
Last updated
06/05/2012
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