Organization
KIMBERLY ANN PRIVITERA, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KIMBERLY PRIVITERA DC (PRESIDENT)
(503) 774-1776
Entity
Organization
Contact information
Practice address
8029 SE WOODSTOCK BLVD, PORTLAND, OR 97206-5885
(503) 774-1776
Mailing address
8029 SE WOODSTOCK BLVD, PORTLAND, OR 97206-5885
(503) 774-1776
Taxonomy
Speciality
Code
Description
License number
State
111NX0100X
Occupational Health Chiropractor
Primary
273094
OR
Other
Enumeration date
05/24/2007
Last updated
08/22/2020
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