Individual
MARIA KRISTINE JIMENEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4560 SE INTERNATIONAL WAY STE 100, MILWAUKIE, OR 97222-4628
(530) 342-4885
Mailing address
4560 SE INTERNATIONAL WAY STE 100, MILWAUKIE, OR 97222-4628
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
4911
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4911
LICENSE NUMBER
—
01
—
NONE
NONE
—
Enumeration date
06/01/2020
Last updated
06/01/2020
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