Individual
MRS. KIMBERLY C LEVINE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, OTR/L
Contact information
Practice address
5232 N INTERSTATE AVENUE, PORTLAND, OR 97217-3460
(503) 449-0788
Mailing address
6135 SE STEPHENS ST, PORTLAND, OR 97215-3460
(503) 265-8897
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
534180
OR
Other
Enumeration date
05/19/2010
Last updated
05/19/2010
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